Individual provider Active NPI

Agnes Kathleen McKeen, LPC

  • Professional Counselor
  • Montgomery, AL
National Provider Identifier
1952346751
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2264 Issued in AL
Practice address
500 Shae Park Rd
Montgomery, AL 36117-3597
Phone
(256) 701-5651
Fax
(256) 429-9411
NPI assigned
Jun 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2264 AL
Professional Counselor 101YP2500X 2264 AL Primary

Addresses

Primary practice location

500 Shae Park Rd
Montgomery, AL 36117-3597

Mailing address

600 Sun Temple Dr
Madison, AL 35758-8643
Phone (256) 975-4291

Other identifiers 3

IdentifierTypeStateIssuer
S-836OtherTHE ASSOCIATION FOR PLAY THERAPY, INC. REGISTERED PLAY THERAPIST AND SUPERVISOR
206738OtherNATIONAL BOARD FOR CERTIFIED COUNSELORS, INC.
2264OtherALTHE BOARD OF EXAMINERS IN COUNSELING STATE OF ALABAMA-LICENSE

Other names 1

  • Agnes K Glaven-McKeen Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20240322000669 AL Practitioner - Mental Health Counselor 4789021007 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Behavioral Health IncGroup PAC ID 7416194113, 109 clinicians

Practice addresses (Care Compare)

500 Shae Park Rd
Montgomery, AL 36117-3597
Phone (334) 270-5502

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2264ALMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Behavioral Health, Inc. Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

600 Sun Temple Dr
Madison, AL 35758
Phone (256) 325-2627

500 Shae Park Rd
Montgomery, AL 36117
Phone (334) 272-3883

1040 Longfield Ct
Montgomery, AL 36117
Phone (334) 288-9009

25850 Main St
Ardmore, TN 38449
Phone (931) 427-4050

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1952346751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 SUN TEMPLE DR",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357588643",
            "telephone_number": "256-975-4291",
            "fax_number": "256-429-9411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SHAE PARK RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173597",
            "telephone_number": "256-701-5651",
            "fax_number": "256-429-9411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEEN",
        "first_name": "AGNES",
        "middle_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-17",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AL",
            "license": "2264",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AL",
            "license": "2264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE ASSOCIATION FOR PLAY THERAPY, INC. REGISTERED PLAY THERAPIST AND SUPERVISOR",
            "identifier": "S-836",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL BOARD FOR CERTIFIED COUNSELORS, INC.",
            "identifier": "206738",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE BOARD OF EXAMINERS IN COUNSELING STATE OF ALABAMA-LICENSE",
            "identifier": "2264",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AGNES",
            "last_name": "GLAVEN-MCKEEN",
            "middle_name": "K",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.