Keitha June Van Ness, LPC
Individual provider Active NPI Mental Health Counselor · Beaumont, TX
NPI 1497087084 · NPPES record last updated Dec 15, 2023
Key facts
- NPI
- 1497087084
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 063886 (TX)
- Practice address
- 4749 Odom Rd
Beaumont, TX 77706-7080 - Phone
- (409) 200-2220
- Fax
- (409) 440-3344
- NPI assigned
- Feb 5, 2010
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Newpath Group
Practice addresses (Care Compare)
4749 Odom Rd
Beaumont, TX 77706-7080
Phone (409) 200-2220
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240104004573 | TX | Practitioner - Mental Health Counselor | 3274984125 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 063886 | TX | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Newpath Group | Mental Health | Current |
Accepting new patients |
Locations
4749 Odom Rd
Beaumont, TX 77706
Phone (409) 200-2220
105 Canyon Lake Cir
Lumberton, TX 77657
Phone (409) 200-2220
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 063886 | TX | Yes |
Addresses
Primary practice location
4749 Odom Rd
Beaumont, TX 77706-7080
Mailing address
105 Canyon Lake Cir
Lumberton, TX 77657-3701
Phone (409) 200-2220
Other providers in Beaumont, TX
- Britt Jerome Valenta
- Valentine Counseling
- Leslie Valentine
- Crissa Jean Vallery
- Avery Valls
- Jennifer Vandehoef
- Gina Vandevender
- Kinnedy Rayne Vandevender
- Timmie Erin Vardell
- Stephanie Renee Vaughan
All providers in Beaumont, TX · Mental Health Counselor in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 15, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.