Renee Keller, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.015007 Issued in IL

Practice address

10551 Vonder Haar LN
Breese, IL 62230-4316

Phone

(618) 520-3339

NPI assigned

Oct 1, 2007

Sex

Female

Sole proprietor

No

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, IL, MO

  Medicare reassignment NPD
• Bridgewater Counseling Services, LLC

  • Clinical Social Worker
  • Breese, IL
  • NPI 1144847880

  Clinical

  NPD Authorized official
• Superior Chiropractic & Rehab

  • Chiropractor
  • Glen Carbon, IL
  • NPI 1033840442
  NPD
• Family Life Consultants, Inc

  • Psychologist
  • Collinsville, IL
  • NPI 1164532248
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in IL, MO2 enrollments

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.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 12, 2024.

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1487841714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10551 VONDER HAAR LN",
            "city": "BREESE",
            "state": "IL",
            "postal_code": "622304316",
            "telephone_number": "618-520-3339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10551 VONDER HAAR LN",
            "city": "BREESE",
            "state": "IL",
            "postal_code": "622304316",
            "telephone_number": "618-520-3339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "RENEE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-01",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.015007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Travis Allen Isaak, D.C.
• Clarece Rose Jansen
• Kelly Jean Kalmer, NP
• Alyssa M Kampwerth, PHARM.D.
• David Louis Kee, DPM
• Jennifer Jo Klostermann, MS, CCC-SLP
• Katy Marie Knolhoff
• Monica J Koch, CCC/SLP
• Megan Lynn Koehler, CNM
• Leslie Kohnen, PT, DPT

• All providers in Breese, IL
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.