Individual provider Active NPI

Michael Francis Keller, RN, LMHC

  • Mental Health Counselor
  • Wesley Chapel, FL
National Provider Identifier
1972209039
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
5008 Issued in FL
Practice address
28945 State Road 54
Suite 102
Wesley Chapel, FL 33543-3351
Phone
(813) 438-5949
Fax
(813) 438-5951
NPI assigned
Jan 31, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 1653572 FL
Mental Health Counselor 101YM0800X 5008 FL Primary

Addresses

Primary practice location

28945 State Road 54
Suite 102
Wesley Chapel, FL 33543-3351

Mailing address

306 West Sadie Street
Brandon, FL 33510
Phone (813) 438-5949

Other identifiers 1

IdentifierTypeStateIssuer
000OtherNONE

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
5008FLMDClinical Psychologist
1653572FLMDGeneral Practice Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Camille Mabin, LCSW LLC CurrentSince Feb 8, 2023 Accepting new patients

Locations

306 W Sadie St
Brandon, FL 33510
Phone (813) 438-5949

28945 Wesley Chapel Blvd
Ste 102
Wesley Chapel, FL 33543
Phone (813) 438-5949

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": "1675123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1972209039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 WEST SADIE STREET",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "33510",
            "telephone_number": "813-438-5949",
            "fax_number": "813-438-5951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28945 STATE ROAD 54",
            "address_2": "SUITE 102",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335433351",
            "telephone_number": "813-438-5949",
            "fax_number": "813-438-5951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "MICHAEL",
        "middle_name": "FRANCIS",
        "credential": "RN, LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-31",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "FL",
            "license": "1653572",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "5008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wesley Chapel, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; 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.