Individual provider Active NPI

Michelle Marie Keller, LCSW

  • Clinical Social Worker
  • Lincoln, NE
National Provider Identifier
1073656807
Registry record updated Jan 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6549 Issued in NE
Practice address
7441 O St Ste 402
Lincoln, NE 68510-2466
Phone
(402) 483-4215
Fax
(402) 483-5228
NPI assigned
Feb 14, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6549 NE Primary

Addresses

Primary practice location

7441 O St Ste 402
Lincoln, NE 68510-2466

Mailing address

7441 O St Ste 402
Lincoln, NE 68510-2466
Phone (402) 483-4215

Other names 1

  • Mrs. Michelle Marie Keller Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140304000033 NE Practitioner - Clinical Social Worker 4082857289 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

7441 O St
Suite 402
Lincoln, NE 68510-2466
Phone (402) 416-2076

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6549NEMDClinical Social Worker
1364NEMDPediatric Occupational Therapist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389916800000",
    "number": "1073656807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7441 O ST STE 402",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102466",
            "telephone_number": "402-483-4215",
            "fax_number": "402-483-5228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7441 O ST STE 402",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102466",
            "telephone_number": "402-483-4215",
            "fax_number": "402-483-5228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2014-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "6549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "KELLER",
            "middle_name": "MARIE",
            "prefix": "MRS.",
            "credential": "LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.