Fox and Ferns Mental Health, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

FOX AND FERNS MENTAL HEALTH, LLC

Practice address

77 Rochelle Ave
Philadelphia, PA 19128-3809

Phone

(215) 704-9832

NPI assigned

Nov 8, 2019

Last updated

Nov 8, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael E. Keesler, JD, PHDNPI 1609228022

Title

Owner

Phone

(215) 704-9832

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael E. Keesler, J.D., PH.D.

  • Clinical Neuropsychologist
  • Philadelphia, PA
  • NPI 1609228022
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1573171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573171200000",
    "number": "1184269664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 ROCHELLE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191283809",
            "telephone_number": "215-704-9832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 ROCHELLE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191283809",
            "telephone_number": "215-704-9832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOX AND FERNS MENTAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-08",
        "last_updated": "2019-11-08",
        "status": "A",
        "authorized_official_last_name": "KEESLER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-704-9832",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "JD, PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drmichaelkeesler@protonmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "77 Rochelle Ave",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191283809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rita A Foust, PA-C
• Andrew David Fowler, MD
• Jessica Fowler, MD, MPH
• Kathryn Fowler, MSS, LSW
• Summer L Fowlkes, MS, LBS
• Fox Chase Adult Day Care Inc.
• Fox Chase Anesthesiology Assoc PC
• Fox Chase Cancer Center
• Fox Chase Cancer Center Medical Group Inc (Anesthesia Assoc of FCCC, MGI)
• Fox Chase Cancer Center Medical Group Inc, (Gastro Assoc of FCCC, MGI)

• Adult Mental Health Clinic/Center in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Adult Mental Health Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.