Individual provider Active NPI

Takela Kenyetta Keech, LCSW, LCASA

  • Clinical Social Worker
  • Raleigh, NC
National Provider Identifier
1336710961
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C020113 Issued in NC
Practice address
2101 Garner Rd
Raleigh, NC 27610-0114
Phone
(919) 787-6131
NPI assigned
Jul 6, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C020113 NC Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCAS-28984 NC

Addresses

Primary practice location

2101 Garner Rd
Raleigh, NC 27610-0114

Mailing address

3125 Poplarwood CT Ste 203
Raleigh, NC 27604-6445
Phone (919) 787-6131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3125 Poplarwood CT
Suite 203
Raleigh, NC 27604-1020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCAS-28984NCMDAddiction (Substance Use Disorder) Counselor
C020113NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southlight Healthcare Addiction (Substance Use Disorder) Past Accepting new patients

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": "1625529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1336710961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 POPLARWOOD CT STE 203",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276046445",
            "telephone_number": "919-787-6131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 GARNER RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276100114",
            "telephone_number": "919-787-6131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEECH",
        "first_name": "TAKELA",
        "middle_name": "KENYETTA",
        "credential": "LCSW, LCASA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-06",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C020113",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-28984",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.