Thomas Keller, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC01644 Issued in MN

Practice address

615 1St Ave NE Ste 310
Minneapolis, MN 55413-2419

Phone

(612) 436-0295

Fax

(612) 436-0163

NPI assigned

Mar 8, 2018

Last updated

Mar 8, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 MN

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Catalyst Mental Health, GBCGroup PAC ID 1355500752, 29 clinicians

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.

• Catalyst Mental Health, GBC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Minneapolis, MN
  • NPI 1134490147
  Medicare reassignment Care Compare group NPD
• Catalyst Mental Health, GBC

  dba Catalyst Mental Health, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mount Dora, FL
  • NPI 1639911167
  NPD

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

{
    "created_epoch": "1520467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520467200000",
    "number": "1598268237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 1ST AVE NE STE 310",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554132419",
            "telephone_number": "612-436-0295",
            "fax_number": "612-436-0163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 1ST AVE NE STE 310",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554132419",
            "telephone_number": "612-436-0295",
            "fax_number": "612-436-0163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "THOMAS",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-08",
        "last_updated": "2018-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC01644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela M Kelle, MD
• Ciana Tress Keller, MD
• Claire A Keller, CPNP
• Jacqueline Keller, LICSW
• Steven L Keller, M.D.
• Quinn Dione Kellerman, PH.D.
• Sarah Kelley-Pegg, NP
• Julia E Kelley, MD
• Linda Kelley, NP
• Ann Kellogg

• Professional Counselor in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2018; 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.