Heidi E Keller, PH.D.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

37PC00325500 Issued in NJ

Practice address

30 Sparta Ave.
Sparta, NJ 07871

Phone

(973) 729-3832

Fax

(973) 729-6114

NPI assigned

Aug 17, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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 Psychologist

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Live Well Psychology Center LLCGroup PAC ID 5799187928, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

• Live Well Psychology Center, LLC

  • Psychologist
  • Sparta, NJ
  • NPI 1902459670
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1187308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187308800000",
    "number": "1801088356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 SPARTA AVE.",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "07871",
            "telephone_number": "973-729-3832",
            "fax_number": "973-729-6114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 SPARTA AVE.",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "07871",
            "telephone_number": "973-729-3832",
            "fax_number": "973-729-6114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "HEIDI",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-17",
        "last_updated": "2007-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37PC00325500",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NY",
            "license": "016695-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Karagiannis Tsekouras, DPT
• Karen Johnson Surgical Assistant LLC
• Kenneth Blair Kashkin
• Rebecca Lynn Keenan, RPT
• Mary Helen Kellam
• Stephanie Theresa Keller, DPT
• Brooke Anne Kennedy Cashion, L.P.C., L.C.A.D.C.
• Christina Kepler, PT
• Seonsook Kim
• Victoria Elizabeth Kish, LAC

• Mental Health Counselor in Sparta, NJ
• Providers in Sparta, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2007; 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.