KELLY KELLER LPC-IT
NPI 1588112643
Counselor - Mental Health in Madison, WI

Q: What is Kelly Keller's NPI number?

The NPI number for Kelly Keller is 1588112643. It was assigned to this individual provider in the NPPES registry on September 19, 2016.

Q: What is Kelly Keller's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Keller was last updated on January 3, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 19, 2016PECOS Enrolled

6333 ODANA RD STE 20, MADISON, WI 53719(608) 270-2511(608) 270-0467 Get Directions Write a Review

NPPES record last updated: January 3, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 3, 2019, Sep 19, 2016 (2 updates tracked since 2016).

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About Kelly Keller Lpc-it NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY KELLER LPC-IT (NPI 1588112643) is an individual mental health provider in Madison, Wisconsin, licensed in Wisconsin (3227 - 226) and active in the NPI registry since September 2016. She is enrolled in Medicare PECOS, maintains a secondary practice location in Reedsburg, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1588112643

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameKELLY KELLERCredential: LPC-IT

Location Address6333 ODANA RD STE 20Madison, WI 53719-1130

Mailing Address6333 Odana Rd Ste 20Madison, WI 53719-1130 · (608) 270-2511 · Fax (608) 270-0467

Phone(608) 270-2511

Fax(608) 270-0467

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateSeptember 19, 2016

Last NPPES UpdateJanuary 3, 20192 updates tracked since enumeration

✔ NPI 1588112643 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in WI · 3227 - 226

6333 ODANA RD STE 20, Madison, WI 53719

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Secondary Practice Location 1

Location 1348 E Main StReedsburg, WI 53959-1940 · Phone (608) 495-9284 · Fax (608) 768-0816

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Group Health Cooperative-SCW, Medica and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly Keller Lpc-it is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8224527668

PECOS Enrollment IDI20251027003963

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNIFER GRABON

Counselor (Professional)