Nicholas Keller, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

19453 Issued in MN

Practice address

2324 University Ave W
Suite 120
Saint Paul, MN 55114-1843

Phone

(651) 212-5386

NPI assigned

Aug 25, 2015

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1440460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440460800000",
    "number": "1811364987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 MISSISSIPPI RIVER BLVD N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551045295",
            "telephone_number": "612-616-8265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2324 UNIVERSITY AVE W",
            "address_2": "SUITE 120",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141843",
            "telephone_number": "651-212-5386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "NICHOLAS",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-25",
        "last_updated": "2015-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "19453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina Marie Keillor, MA, CCC-SLP
• Valerie Mae Kellen George, RDH
• Charles Anthony Keller, D.D.S.
• Curtis D Keller, MD
• Kyle Keller
• Stephannie L Keller
• Britni Kelley, MA
• Joan Kelley
• Marianne P Kelley, PSYD LP
• Margaret B Kellogg, M.A., L.P.

• Clinical Social Worker in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.