Thomas S Keller, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34006533A Issued in IN

Practice address

420 W 4TH St
Mishawaka, IN 46544-1948

Phone

(574) 307-7673

Fax

(574) 307-7692

NPI assigned

Mar 6, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Clinical Social Worker

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthlinc IncGroup PAC ID 7618929373, 83 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Healthlinc, Inc.

  • Federally Qualified Health Center (FQHC)
  • Valparaiso, IN
  • NPI 1528262581
  Medicare reassignment Care Compare group NPD
• Oaklawn Psychiatric Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Elkhart, IN
  • NPI 1598847212
  Medicare reassignment NPD
• Healthlinc, Inc

  dba HealthLinc - Newton

  • Federally Qualified Health Center (FQHC)
  • Morocco, IN
  • NPI 1568354116
  NPD
• Healthlinc, Inc.

  • Federally Qualified Health Center (FQHC)
  • Mishawaka, IN
  • NPI 1417244989
  NPD
• Oaklawn Psychiatric Center, Inc.

  • Psychiatric Hospital
  • Goshen, IN
  • NPI 1467407395
  NPD
• Latitudes, Inc

  • Counselor
  • Granger, IN
  • NPI 1588079057
  NPD (past)

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

{
    "created_epoch": "1330992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1376817510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 W 4TH ST",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465441948",
            "telephone_number": "574-307-7673",
            "fax_number": "574-307-7692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W 4TH ST",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465441948",
            "telephone_number": "574-307-7673",
            "fax_number": "574-307-7692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "THOMAS",
        "middle_name": "S",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-06",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149007563",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34006533A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Elaine Kay, MA, BCBA
• Kaitlyn Kazmierzak, PT, DPT
• Mekdes Kebede
• Taft Keele, MD
• Karlee Keiper, LCSW
• Rebecca Kelver, RBT
• Mechelle E Kemp, RN
• Allyssa Marie Kempf
• Kenmark Home Care, LLC
• Marie Antoinette Kennedy

• Clinical Social Worker in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; 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.