Kaitlyn Marie Keen, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801111316 Issued in MI

Practice address

801 Hazen St Ste C
Paw Paw, MI 49079-2008

Phone

(269) 657-5574

NPI assigned

Apr 9, 2020

Last updated

Oct 15, 2024By the provider in NPPES

Sex

Female

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

Enrolled in MI

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

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Van Buren Community Mental Health AuthorityGroup PAC ID 6800863788, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Van Buren Community Mental Health Authority

  • Psychiatry Physician
  • Paw Paw, MI
  • NPI 1003878554
  Medicare reassignment Care Compare group
• Cherry Street Services, Inc.

  dba Cherry Street Health Services

  • Federally Qualified Health Center (FQHC)
  • Grand Rapids, MI
  • NPI 1558459164
  Medicare reassignment NPD
• Cherry Street Services, Inc

  dba Cherry Health - Tri County Middle School

  • Federally Qualified Health Center (FQHC)
  • Howard City, MI
  • NPI 1831955251

  Clinical

  NPD

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

{
    "created_epoch": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1578182788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 HAZEN ST STE C",
            "city": "PAW PAW",
            "state": "MI",
            "postal_code": "490792008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 HAZEN ST STE C",
            "city": "PAW PAW",
            "state": "MI",
            "postal_code": "490792008",
            "telephone_number": "269-657-5574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEN",
        "first_name": "KAITLYN",
        "middle_name": "MARIE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-09",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801111316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kanaan Therapy and Behavioral Health Services, LLC
• Paula Renee Kanaan, LMSW
• Timothy Adli Kanaan, LPC
• Wade Addam Kapik, LLP
• John W Kavanaugh Jr., MD
• Stacy Michelle Kelemen
• Kay Keller
• Alexis Kelly, OTR-L
• Deborah Jean Kelly, LPC
• Lynn James Kern, M.D.

• Clinical Social Worker in Paw Paw, MI
• Providers in Paw Paw, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.