Kimberly Rae Keisel, MA, LLPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

6401009294 Issued in MI

Practice address

806 Tuuri PL
Flint, MI 48503-2465

Phone

(810) 767-5750

NPI assigned

Jan 10, 2007

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

Other names 1

• Miss Kimberly Rae Stam Former name

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optum Behavioral Care of Colorado PCGroup PAC ID 0941648463, 196 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kimberly.keisel.1@28621.direct.athenahealth.com

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.

• Optum Behavioral Care of Colorado, P.C.

  • Clinical Psychologist
  • Bloomfield Hills, MI
  • NPI 1851161285
  Medicare reassignment Care Compare group NPD
• Richard Kneip, PH.D., P.C.

  • Community/Behavioral Health Agency
  • Clarkston, MI
  • NPI 1679739700
  Medicare reassignment
• Oakland Psychological Clinic, P.C.

  • Mental Health Counselor
  • Flint, MI
  • NPI 1538356282
  NPD
• Optum Behavioral Care of Colorado, P.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bloomfield Hills, MI
  • NPI 1376300616
  NPD
• Optum Behavioral Care of Colorado, P.C.

  • Clinical Social Worker
  • De Pere, WI
  • NPI 1396622494
  NPD

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285784736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 TUURI PLACE",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "48503",
            "telephone_number": "810-767-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 TUURI PL",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485032465",
            "telephone_number": "810-767-5750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEISEL",
        "first_name": "KIMBERLY",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "MA, LLPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401009294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "STAM",
            "middle_name": "RAE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Victoria T Keels
• Kathleen Rose Keenan, M.S. CCC-SLP
• Demetrius Antoine Keener
• Kaitlin Ashlee Keener
• Keilen Shoes
• Keith B Daniels DPM PC
• Keith Specialized Residential Services, LLC
• Linda A Kelleghan
• Haley Keller, NP-C
• Stephanie N Keller

• Counselor in Flint, MI
• Providers in Flint, MI by specialty
• Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.