Keelie Wimberley

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

E.2404548 Issued in OH

Practice address

750 E Long St
Columbus, OH 43203-1846

Phone

(614) 340-6700

NPI assigned

Oct 28, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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

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.

• Equitas Health,Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Columbus, OH
  • NPI 1518227453
  Medicare reassignment NPD
• Equitas Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Toledo, OH
  • NPI 1063239911
  NPD
• Equitas Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Dayton, OH
  • NPI 1255846515
  NPD (past)

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1891338315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 BETHESDA DR UNIT 4",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437010815",
            "telephone_number": "740-201-2324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E LONG ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432031846",
            "telephone_number": "614-340-6700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "930 Bethesda Dr Unit 4",
            "address_purpose": "LOCATION",
            "city": "Zanesville",
            "state": "OH",
            "postal_code": "437010815",
            "country_code": "US",
            "telephone_number": "740-201-2324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIMBERLEY",
        "first_name": "KEELIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-28",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.2204115",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "C.2204115",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.2404548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@midohiobh.com",
            "affiliation": "N",
            "address_1": "930 Bethesda Dr Unit 4",
            "city": "Zanesville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "437010815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tonya Wilson
• Tracy Wilson, QMHS
• Claire Wilt, RD, LD
• Roger D Wilt, M.D.
• Charles Wiltrout, M.D.
• Stinner Wimberly-Shine
• Evin Wimberly, MSW, LSW
• Carol Winborne
• Danielle T. Winch, C.R.N.A.
• Peter D Winch, MD

• Mental Health Counselor in Columbus, OH
• Providers in Columbus, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.