Kristen G. Keteltas, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

13777 Issued in MD

Practice address

15701 Crabbs Branch Way
Rockville, MD 20855-2634

Phone

(301) 251-8965

NPI assigned

Sep 3, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DC

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 Social Worker

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Willow Oak Therapy Center, IncGroup PAC ID 5698661023, 18 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 and National Provider Directory roles.

• Willow Oak Therapy Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rockville, MD
  • NPI 1386620581

  DC

  Medicare reassignment Care Compare group NPD
• Jody Tabner Thayer LLC

  • Clinical Social Worker
  • Bethesda, MD
  • NPI 1871064535
  NPD (past)

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1821246893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15701 CRABBS BRANCH WAY",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208552634",
            "telephone_number": "301-251-8965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15701 CRABBS BRANCH WAY",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208552634",
            "telephone_number": "301-251-8965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETELTAS",
        "first_name": "KRISTEN",
        "middle_name": "G.",
        "name_prefix": "Ms.",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-03",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "13777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "816700100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• April Kerwood
• Frances-Ann Kese
• David Bryn Kessler, M.D.
• Katrina Kessler
• Leslie Fradkin Kessler, LCSW C LICSW
• Jessica Ketterman
• Kevin M Gil, MD LLC
• Key West Crossing Dental Associates
• Liza Key
• Shauniqua Key

• Clinical Social Worker in Rockville, MD
• Providers in Rockville, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; 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.