Loretta Busby Keelin, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C003027 Issued in NC

Practice address

824 Gum Branch Rd
Suite O
Jacksonville, NC 28540-6269

Phone

(910) 938-9338

Fax

(910) 989-0377

NPI assigned

Jun 18, 2006

Sex

Female

Sole proprietor

Yes

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)

Enrolled

State licenses

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1477598936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 W IH 10 STE 300",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782304776",
            "telephone_number": "910-938-9338",
            "fax_number": "910-989-0377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 GUM BRANCH RD",
            "address_2": "SUITE O",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285406269",
            "telephone_number": "910-938-9338",
            "fax_number": "910-989-0377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEELIN",
        "first_name": "LORETTA",
        "middle_name": "BUSBY",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-18",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C003027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; 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.