Paul Kellett Van Leer

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LGPC00397 Issued in DC

Practice address

2704 Dumbarton St NW
Washington, DC 20007-3321

Phone

(202) 876-4171

NPI assigned

Jun 1, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 27, 2024 through Mar 27, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1527811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527811200000",
    "number": "1962994269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 DUMBARTON ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200073321",
            "telephone_number": "202-876-4171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 DUMBARTON ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200073321",
            "telephone_number": "202-876-4171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1112 16th St NW Ste 440",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200364820",
            "country_code": "US",
            "telephone_number": "202-876-4171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLETT VAN LEER",
        "first_name": "PAUL",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-01",
        "last_updated": "2018-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": null,
            "license": "06158139",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "DC",
            "license": "LGPC00397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kali Keller, PT
• Mary Ann Keller, RN
• Michael Daniel Keller, MD
• Richard Dempsey Keller, REHAB ENGINEER
• Roxane Keller, MA, MS, LPC, RMHCI
• Alexis Kelley
• Ashley Journette Kelley
• Benjamin Kelley, D.D.S.
• Demetrius Kelley
• Demi W Kelley, RN

• Professional Counselor in Washington, DC
• Providers in Washington, DC by specialty
• Professional Counselor in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.