Active NPI
Christine Emily Keller, LCSW
- Clinical Social Worker
- Bend, OR
National Provider Identifier
1447545173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- L4262
- Practice address
- 2115 NE Wyatt CT
Suite 201
Bend, OR 97701-7678 - Phone
- (541) 647-5226
- NPI assigned
- Jun 10, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | L4262 | OR | Primary |
Addresses
Primary practice location
2115 NE Wyatt CT
Suite 201
Bend, OR 97701-7678
Mailing address
2115 NE Wyatt Court, Suite 201
Veterans Affairs Clinic
Bend, OR 97701
Phone (541) 647-5226
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L4262 | OR | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307664000000",
"number": "1447545173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2115 NE WYATT COURT, SUITE 201",
"address_2": "VETERANS AFFAIRS CLINIC",
"city": "BEND",
"state": "OR",
"postal_code": "97701",
"telephone_number": "541-647-5226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2115 NE WYATT CT",
"address_2": "SUITE 201",
"city": "BEND",
"state": "OR",
"postal_code": "977017678",
"telephone_number": "541-647-5226"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLER",
"first_name": "CHRISTINE",
"middle_name": "EMILY",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-10",
"last_updated": "2011-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "L4262",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.