Kelly Keller, LPC-IT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

3227 - 226 Issued in WI

Practice address

6333 Odana Rd Ste 20
Madison, WI 53719-1130

Phone

(608) 270-2511

Fax

(608) 270-0467

NPI assigned

Sep 19, 2016

Last updated

Jan 3, 2019By 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 WI

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

Mental Health Counselor

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Orion Family Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Madison, WI
  • NPI 1154529972
  Medicare reassignment NPD
• Orion Family Services, Inc.

  • Community/Behavioral Health Agency
  • Madison, WI
  • NPI 1215122668
  NPD
• Cullain LLC

  • Psychiatry Physician
  • Madison, WI
  • NPI 1538446828
  NPD (past)
• Therapy Without Walls

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Reedsburg, WI
  • NPI 1003215310
  NPD (past)

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

{
    "created_epoch": "1474243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1588112643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6333 ODANA RD STE 20",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191130",
            "telephone_number": "608-270-2511",
            "fax_number": "608-270-0467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6333 ODANA RD STE 20",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191130",
            "telephone_number": "608-270-2511",
            "fax_number": "608-270-0467"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "348 E Main St",
            "address_purpose": "LOCATION",
            "city": "Reedsburg",
            "state": "WI",
            "postal_code": "539591940",
            "country_code": "US",
            "telephone_number": "608-495-9284",
            "fax_number": "608-768-0816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLER",
        "first_name": "KELLY",
        "credential": "LPC-IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-19",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "3227 - 226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryony Kelleher
• Erin Frances Kelleher
• Amanda Marie Keller, OD
• Anne D Keller, LCSW
• Dean R Keller, MD
• Lisa Keller, CPNP
• Peyton Glenn Keller, MD
• Rachel Keller
• Jennifer Lynn Kellerhuis, MED, LAT, ATC
• Claire K Kellesvig, LPC-IT

• Mental Health Counselor in Madison, WI
• Providers in Madison, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2019; 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.