Active NPI
Carol Keller, LCPC, NCC
- Professional Counselor
- Gaithersburg, MD
National Provider Identifier
1871921700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LC6477
- Practice address
- 12105 Darnestown Rd
Suite 28
Gaithersburg, MD 20878-2217 - Phone
- (301) 569-0134
- NPI assigned
- Nov 1, 2013
- Last updated
- Dec 5, 2016
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LC6477 | MD | Primary |
Addresses
Primary practice location
12105 Darnestown Rd
Suite 28
Gaithersburg, MD 20878-2217
Mailing address
12105 Darnestown Rd
Suite 28
Gaithersburg, MD 20878-2217
Phone (301) 569-0134
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 099789700 | Medicaid | MD |
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 |
|---|---|---|---|
| LC6477 | MD | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480896000000",
"number": "1871921700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12105 DARNESTOWN RD",
"address_2": "SUITE 28",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208782217",
"telephone_number": "301-569-0134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12105 DARNESTOWN RD",
"address_2": "SUITE 28",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208782217",
"telephone_number": "301-569-0134"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLER",
"first_name": "CAROL",
"credential": "LCPC, NCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-11-01",
"last_updated": "2016-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LC6477",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "099789700",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gaithersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.