Active NPI
Kristen M Keller
- Professional Counselor
- Dublin, OH
National Provider Identifier
1780190769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- C.2103311
- Practice address
- 200 W Bridge St Ste B
Dublin, OH 43017-1141 - Phone
- (614) 547-9233
- NPI assigned
- Dec 28, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | C.2103311 | OH | Primary |
Addresses
Primary practice location
200 W Bridge St Ste B
Dublin, OH 43017-1141
Mailing address
200 W Bridge St Ste B
Dublin, OH 43017-1141
Phone (614) 547-9233
Other practice location 1
187 W Schrock Rd
Westerville, OH 43081-2890
Phone (614) 355-7500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2846675 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C.2103311 | OH | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623369600000",
"number": "1780190769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 W BRIDGE ST STE B",
"city": "DUBLIN",
"state": "OH",
"postal_code": "430171141",
"telephone_number": "614-547-9233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 W BRIDGE ST STE B",
"city": "DUBLIN",
"state": "OH",
"postal_code": "430171141",
"telephone_number": "614-547-9233"
}
],
"practiceLocations": [
{
"address_1": "187 W Schrock Rd",
"address_purpose": "LOCATION",
"city": "Westerville",
"state": "OH",
"postal_code": "430812890",
"country_code": "US",
"telephone_number": "614-355-7500",
"fax_number": "614-355-7533",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KELLER",
"first_name": "KRISTEN",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-28",
"last_updated": "2021-06-11",
"certification_date": "2021-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "C.2103311",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2846675",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dublin, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.