Individual provider Active NPI

Keller Bell, RADT-1

  • Addiction (Substance Use Disorder) Counselor
  • Long Beach, CA
National Provider Identifier
1205560844
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
5190 Atlantic Ave
Long Beach, CA 90805-6510
Phone
(949) 524-0240
NPI assigned
Jul 11, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X CA
Addiction (Substance Use Disorder) Counselor 101YA0400X CA Primary

Addresses

Primary practice location

5190 Atlantic Ave
Long Beach, CA 90805-6510

Mailing address

5190 Atlantic Ave
Long Beach, CA 90805-6510
Phone (949) 524-0240

Other practice location 1

23161 Mill Creek Dr Ste 230
Laguna Hills, CA 92653-7935
Phone (949) 264-5350

Other practice location 2

12141 Brookhurst St Ste 201
Garden Grove, CA 92840-2865
Phone (657) 261-7140

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

Practice roles

OrganizationSpecialtyStatusNew patients
Telecare Corporation CurrentSince Jul 1, 2022 Accepting new patients

Locations

12141 Brookhurst St
Ste 201
Garden Grove, CA 92840
Phone (657) 261-7140

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": "1657497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1205560844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5190 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908056510",
            "telephone_number": "949-524-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5190 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908056510",
            "telephone_number": "949-524-0240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23161 Mill Creek Dr Ste 230",
            "address_purpose": "LOCATION",
            "city": "Laguna Hills",
            "state": "CA",
            "postal_code": "926537935",
            "country_code": "US",
            "telephone_number": "949-264-5350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12141 Brookhurst St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Garden Grove",
            "state": "CA",
            "postal_code": "928402865",
            "country_code": "US",
            "telephone_number": "657-261-7140",
            "fax_number": "714-922-1032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BELL",
        "first_name": "KELLER",
        "credential": "RADT-1",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-11",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; 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.