NPIMap

Organization Active NPI

Wendy Keller, LCSW, LLC

  • Clinical Social Worker
  • Newburgh, NY
National Provider Identifier
1982992889
Registry record updated Jun 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R055693 Issued in NY
Legal business name
WENDY KELLER, LCSW, LLC
Practice address
633 Gidney Ave
Suite 2
Newburgh, NY 12550
Phone
(845) 242-8375
Fax
(866) 619-5710
NPI assigned
Jul 13, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2018

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

Authorized official

Name
Wendy Keller, LCSWNPI 1467534925
Title
President
Phone
(845) 242-8375

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X R055693 NY Primary

Addresses

Primary practice location

633 Gidney Ave
Suite 2
Newburgh, NY 12550

Mailing address

633 Gidney Ave Ste 4-6
Newburgh, NY 12550-2800
Phone (845) 242-8375

Other names 1

  • Behavioral Health Services of the Hudson Valley Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111020000186 NY Part B Supplier - Clinic/Group Practice 7810169646 Receives reassigned benefits from 12 practitioners
Practice locations: Newburgh, NY

National Provider Directory

National Provider Directory

Locations

633 Gidney Ave
Ste 6
Newburgh, NY 12550
Phone (845) 242-8375

633 Gidney Ave
Ste 46
Newburgh, NY 12550

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1310515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529280000000",
    "number": "1982992889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 GIDNEY AVE STE 4-6",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125502800",
            "telephone_number": "845-242-8375",
            "fax_number": "866-619-5710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 GIDNEY AVE",
            "address_2": "SUITE 2",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "12550",
            "telephone_number": "845-242-8375",
            "fax_number": "866-619-5710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WENDY KELLER, LCSW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-13",
        "last_updated": "2018-06-18",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "845-242-8375",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R055693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Behavioral Health Services of the Hudson Valley",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Behavioral Health Services of the Hudson Valley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newburgh, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.