Douglas Freeman Kellenberger, MA, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

6202 Constitution Dr Ste D
Fort Wayne, IN 46804-1583

Phone

(260) 432-0066

Fax

(260) 432-8503

NPI assigned

Aug 25, 2008

Sex

Male

Sole proprietor

No

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)

Not enrolled

Credentials

Master of Arts

Practice roles

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.

• Lifeworks Counseling & Consulting, Inc.

  • Professional Counselor
  • Fort Wayne, IN
  • NPI 1184886541
  NPD (past)

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

{
    "created_epoch": "1219622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456358400000",
    "number": "1528215266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 LEXINGTON AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468072126",
            "telephone_number": "260-410-7565",
            "fax_number": "260-456-8425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6202 CONSTITUTION DR STE D",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041583",
            "telephone_number": "260-432-0066",
            "fax_number": "260-432-8503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLENBERGER",
        "first_name": "DOUGLAS",
        "middle_name": "FREEMAN",
        "credential": "MA, LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-25",
        "last_updated": "2016-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alissa Ann Keillor
• Abby Lynn Keiser, PHARMD
• Catherine Keith
• James Adam Keith, MD, MS
• Kristen G Keitzer, RN
• Alyssa Keller, OT
• Diana Maria Keller, PTA
• Lauren Keller
• Linda Maye Keller
• Nicole Keller, MT-BC

• Mental Health Counselor in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2016; 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.