Individual provider Active NPI

Kelsey Keane, LPC

  • Mental Health Counselor
  • Fairfax, VA
National Provider Identifier
1487421004
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0701013096 Issued in VA
Practice address
8221 Willow Oaks Corporate Dr
Fairfax, VA 22031-4512
Phone
(703) 559-3000
NPI assigned
Dec 4, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0701013096 VA Primary

Addresses

Primary practice location

8221 Willow Oaks Corporate Dr
Fairfax, VA 22031-4512

Mailing address

8221 Willow Oaks Corporate Dr
Fairfax, VA 22031-4512
Phone (703) 559-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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

Enrollment IDStateProvider typePAC IDDetails
I20231227003410 DC Practitioner - Mental Health Counselor 7719337120 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fairfax County, Virginia CurrentSince Jan 1, 2024 Accepting new patients

Locations

12011 Government Center Pkwy
Ste 836
Fairfax, VA 22035
Phone (703) 324-7017

8221 Willow Oaks Corporate Dr
Fairfax, VA 22031
Phone (703) 289-7599

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": "1701648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1487421004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8221 WILLOW OAKS CORPORATE DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314512",
            "telephone_number": "703-559-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8221 WILLOW OAKS CORPORATE DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314512",
            "telephone_number": "703-559-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEANE",
        "first_name": "KELSEY",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-04",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701013096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.