Sharon Donnelly Keller, M.S., L.C.P.C.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

39002503A Issued in IN

Practice address

6910 N Main St, Unit 13C
Box 51
Granger, IN 46530-9681

Phone

(574) 524-6307

Fax

(574) 222-1507

NPI assigned

Jan 11, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Sharon Ann Donnelly Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Latitudes, Inc

  • Counselor
  • Granger, IN
  • NPI 1588079057
  NPD (past) Authorized official

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1881744787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50771 PHEASANT COVE DR",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465309500",
            "telephone_number": "574-524-6307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6910 N MAIN ST, UNIT 13C",
            "address_2": "BOX 51",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465309681",
            "telephone_number": "574-524-6307",
            "fax_number": "574-222-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "SHARON",
        "middle_name": "DONNELLY",
        "credential": "M.S., L.C.P.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401018507",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180-004245",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39002503A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHARON",
            "last_name": "DONNELLY",
            "middle_name": "ANN",
            "credential": "M.S., L.C.P.C.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alison Marie Kartz, HIS
• Kevin P Kaufhold, MD
• Shanna Verma Kautzmann, M.D.
• Hasaan Amer Kazi, MD
• Anna Keller, RBT
• James Patrick Kelly, MD, MBA
• Amy R. Kendall, OTR
• Michele Renae Kenney
• Lori Lynn Kerr
• Natalie Kilheeney, L.AC., DIPL. O.M.

• Mental Health Counselor in Granger, IN
• Providers in Granger, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; 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.