Clarissa Keller, MS

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6352000864 Issued in MI

Practice address

1050 Willshire Dr Ste 175
Detroit, MI 48277-0001

Phone

(800) 693-1916

NPI assigned

Aug 30, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Richard Kneip, PH.D., P.C.

  • Community/Behavioral Health Agency
  • Clarkston, MI
  • NPI 1679739700
  NPD (past)

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

{
    "created_epoch": "1724976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1265266274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4512 INTERNATIONAL CT # D69",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491031751",
            "telephone_number": "269-362-4635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 WILLSHIRE DR STE 175",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482770001",
            "telephone_number": "800-693-1916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "CLARISSA",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-30",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6352000864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katy Keith
• Laura Keith, MSW
• Gloria Kekalos Allum, M.S.W., L.M.S.W.
• Alana Jordan Keller
• Christian Ernst Keller, M.D.
• Katie Alanna Keller, D.O.
• Latasha Keller
• Melissa Renee Keller, PA-C
• Ruston Keller
• Suzanne Lynn Keller, PHD

• Psychologist in Detroit, MI
• Providers in Detroit, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.