Individual provider Active NPI

Kimberly Louise Keon

  • Mental Health Counselor
  • Munster, IN
National Provider Identifier
1134865322
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
88001118A Issued in IN
Practice address
720 45TH St
Munster, IN 46321-2818
Phone
(219) 852-2513
Fax
(317) 865-1479
NPI assigned
May 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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 88001118A IN Primary

Addresses

Primary practice location

720 45TH St
Munster, IN 46321-2818

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other practice location 1

350 Indian Boundary Rd
Chesterton, IN 46304-1511
Phone (219) 308-1570

Other practice location 2

9111 Broadway Ste N
Merrillville, IN 46410-7097
Phone (219) 791-1006

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL MedicsCloud Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20241205000673 IN Practitioner - Mental Health Counselor 0840726584 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians
Animal Assisted Counseling of IndianaGroup PAC ID 8820524408, 2 clinicians

Practice addresses (Care Compare)

720 45TH St
Munster, IN 46321-2818
Phone (219) 852-2513

900 Ridge Rd
Suite T
Munster, IN 46321-1727
Phone (219) 213-6009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
88001118AINMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Animal Assisted Counseling of Indiana Mental Health CurrentSince Oct 19, 2024 Accepting new patients
Parkdale Center LLC Addiction (Substance Use Disorder) CurrentSince May 22, 2022 Accepting new patients
Parkdale Center LLC Addiction (Substance Use Disorder) PastSince May 16, 2022 Accepting new patients

Locations

350 Indian Boundary Rd
Chesterton, IN 46304
Phone (219) 929-5367

9111 Broadway
Ste N
Merrillville, IN 46410
Phone (219) 791-1006

900 Ridge Rd
Ste T
Munster, IN 46321
Phone (219) 213-6009

Organizations & group practices 4

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": "1652140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1134865322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 45TH ST",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212818",
            "telephone_number": "219-852-2513",
            "fax_number": "317-865-1479"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 Indian Boundary Rd",
            "address_purpose": "LOCATION",
            "city": "Chesterton",
            "state": "IN",
            "postal_code": "463041511",
            "country_code": "US",
            "telephone_number": "219-308-1570",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9111 Broadway Ste N",
            "address_purpose": "LOCATION",
            "city": "Merrillville",
            "state": "IN",
            "postal_code": "464107097",
            "country_code": "US",
            "telephone_number": "219-791-1006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEON",
        "first_name": "KIMBERLY",
        "middle_name": "LOUISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-10",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "88001118A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "MedicsCloud",
            "affiliation": "N",
            "endpointDescription": "Electronic EMR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Electronic",
            "address_1": "350 Indian Boundary Rd",
            "city": "Chesterton",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463041511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.