Kimly Keeton, LCSW, LCAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34006482A Issued in IN

Practice address

809 Jefferson Ave
La Porte, IN 46350-3431

Phone

(219) 898-5646

NPI assigned

Jan 23, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1421971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456963200000",
    "number": "1548650930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 BEAUTY CREEK RUN",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463857049",
            "telephone_number": "219-741-8895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 JEFFERSON AVE",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463503431",
            "telephone_number": "219-898-5646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEETON",
        "first_name": "KIMLY",
        "credential": "LCSW, LCAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-23",
        "last_updated": "2016-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "87001395A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34006482A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nadeem U Kamran, M.D.
• Jessica Kane, NP-F
• Mtisunge Erica Kapalamula
• Manogna Katakam, DDS
• Raymond Joseph Keener, MSN FNP-BC
• Rachel N Kennedy, FNP
• Keys Counseling, Inc
• Faiz Ullah Khan, MD
• Mohammed Hyder Ali Khan
• Shaan Khan, M.D.

• Clinical Social Worker in La Porte, IN
• Providers in La Porte, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.