Active NPI
Ellen M Keyser, LPC
- Counselor
- Lakeport, MI
National Provider Identifier
1861505802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 6401223525
- Practice address
- 3616 Washington St
Lakeport, MI 48059-1965 - Phone
- (810) 984-4202
- NPI assigned
- Aug 16, 2006
- Last updated
- Nov 6, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 6401223525 | MI | Primary |
Addresses
Primary practice location
3616 Washington St
Lakeport, MI 48059-1965
Mailing address
3616 Washington St
Lakeport, MI 48059-1965
Phone (810) 824-2088
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 |
|---|---|---|---|
| 6401223525 | MI | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Richard Kneip, PH.D., P.C. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Great Lakes Psychology Group
- Community/Behavioral Health Agency
- Clarkston, MI
- NPI 1679739700
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699228800000",
"number": "1861505802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3616 WASHINGTON ST",
"city": "LAKEPORT",
"state": "MI",
"postal_code": "480591965",
"telephone_number": "810-824-2088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3616 WASHINGTON ST",
"city": "LAKEPORT",
"state": "MI",
"postal_code": "480591965",
"telephone_number": "810-984-4202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEYSER",
"first_name": "ELLEN",
"middle_name": "M",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-16",
"last_updated": "2023-11-06",
"certification_date": "2023-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MI",
"license": "6401223525",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeport, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.