Tracy C Keller, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5702 Issued in WI

Practice address

6980 N Port Washington Rd
Ste 202
Milwaukee, WI 53217

Phone

(414) 351-7100

Fax

(414) 247-4082

NPI assigned

May 27, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Tracy Stuettgen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1432684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1245619907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6980 N PORT WASHINGTON RD",
            "address_2": "STE 202",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532173900",
            "telephone_number": "414-351-7100",
            "fax_number": "414-247-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6980 N PORT WASHINGTON RD",
            "address_2": "STE 202",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53217",
            "telephone_number": "414-351-7100",
            "fax_number": "414-247-4082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "TRACY",
        "middle_name": "C",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-27",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "1903-226",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "5702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "STUETTGEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ervin Lamont Keller Jr.
• Jamie Elaine Keller, CADCIII
• Joshua Keller
• Katelyn Rose Keller
• Mary Margaret Keller, APNP
• Kelley Clinic LLC
• Shannon Rae Kelley-Poulos, PSYD
• Brian Kelley
• Briana Kelley, CNA
• Elizabeth Caroline Kelley, MS/CCC-SLP

• Professional Counselor in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2018; 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.