Active NPI
Stephanie Keeler
- Counselor
- Mattawan, MI
National Provider Identifier
1174096317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 6401014410
- Practice address
- 24305 Brownstone Blvd
Mattawan, MI 49071-7815 - Phone
- (269) 929-4443
- NPI assigned
- Jan 10, 2019
- Last updated
- Jan 10, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 6401014410 | MI | Primary |
Addresses
Primary practice location
24305 Brownstone Blvd
Mattawan, MI 49071-7815
Mailing address
24305 Brownstone Blvd
Mattawan, MI 49071-7815
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6401014410 | MI | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547078400000",
"number": "1174096317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24305 BROWNSTONE BLVD",
"city": "MATTAWAN",
"state": "MI",
"postal_code": "490717815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24305 BROWNSTONE BLVD",
"city": "MATTAWAN",
"state": "MI",
"postal_code": "490717815",
"telephone_number": "269-929-4443"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEELER",
"first_name": "STEPHANIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-10",
"last_updated": "2019-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MI",
"license": "6401014410",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mattawan, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.