Keith Hageman, LPC
Individual provider Active NPI Professional Counselor · Casper, WY
NPI 1629779012 · NPPES record last updated Aug 28, 2024
Key facts
- NPI
- 1629779012
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- LPC-2336 (WY)
- Practice address
- 5000 Blackmore Rd
Casper, WY 82609-3345 - Phone
- (307) 233-6000
- Fax
- (307) 233-6089
- NPI assigned
- Mar 13, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Community Health Center of Central Wyoming Inc
Practice addresses (Care Compare)
5000 Blackmore Rd
Casper, WY 82609-3345
Phone (307) 233-6000
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240905002325 | WY | Practitioner - Mental Health Counselor | 5698215648 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-2336 | WY | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Health Center of Central Wyoming, Inc. | Current |
Accepting new patients | |
| Community Health Center of Central Wyoming Inc | Past | Accepting new patients | |
| Community Health Center of Central Wyoming Inc | Past | Accepting new patients | |
| Community Health Center of Central Wyoming Inc | Past | Accepting new patients |
Locations
5000 Blackmore Rd
Casper, WY 82609
Phone (307) 233-6000
1035 Rose Ln
Riverton, WY 82501
Phone (307) 463-6300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC-2336 | WY | Yes |
Addresses
Primary practice location
5000 Blackmore Rd
Casper, WY 82609-3345
Mailing address
5000 Blackmore Rd
Casper, WY 82609-3345
Other providers in Casper, WY
- Ann M Haack
- James Byrd Haden
- Miranda Ann Haefele
- Peter A Haftkowycz
- Reed Ray Haga
- Kyra K Hageman
- Robert Allan Hageman
- Brittany Hager
- Mary Sue Hager
- Jamaica Hahn
All providers in Casper, WY · Professional Counselor in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 28, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.