Individual provider Active NPI

Martha A Keesler, LMSW

  • Mental Health Counselor
  • Ogdensburg, NY
National Provider Identifier
1063437655
Registry record updated Aug 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
070332 Issued in NY
Practice address
109 Ford St
Ogdensburg, NY 13669-1419
Phone
(315) 394-0101
Fax
(315) 394-0097
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 070332 NY Primary

Addresses

Primary practice location

109 Ford St
Ogdensburg, NY 13669-1419

Mailing address

109 Ford St
Ogdensburg, NY 13669-1419
Phone (315) 394-0101

Other identifiers 1

IdentifierTypeStateIssuer
07200070332LIMedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
070332NYMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406851200000",
    "number": "1063437655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 FORD ST",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136691419",
            "telephone_number": "315-394-0101",
            "fax_number": "315-394-0097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 FORD ST",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136691419",
            "telephone_number": "315-394-0101",
            "fax_number": "315-394-0097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEESLER",
        "first_name": "MARTHA",
        "middle_name": "A",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2014-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "070332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07200070332LI",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogdensburg, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.