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KEENYN WALD LPC
NPI 1710598255
Counselor - Mental Health in Columbus, MS

Active since August 10, 2020PECOS Enrolled
1011 MAIN ST, COLUMBUS, MS 39701(662) 327-7916 Get Directions Write a Review

NPPES record last updated: October 15, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 15, 2020, Aug 10, 2020 (2 updates tracked since 2020).

About Keenyn Wald Lpc NPPES

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

KEENYN WALD LPC (NPI 1710598255) is an individual mental health provider in Columbus, Mississippi, licensed in Mississippi (1834) and active in the NPI registry since August 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1710598255
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameKEENYN WALDCredential: LPC
Location Address1011 MAIN STColumbus, MS 39701-4751
Mailing Address302 N Jackson StStarkville, MS 39759-2504 · (662) 327-7916
Phone(662) 327-7916
Sole ProprietorNo
Enumeration DateAugust 10, 2020
Last NPPES UpdateOctober 15, 20202 updates tracked since enumeration
NPPES CertifiedAugust 13, 2020
✔ NPI 1710598255 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in MS · 1834
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 1834 (MS)
1011 MAIN ST, Columbus, MS 39701
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Keenyn Wald Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 7

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

EMILY ROBERTS
Counselor (Addiction (Substance Use Disorder))
1011 MAIN ST
COLUMBUS, MS 39701
Lowndes County (662) 327-7916
SHLANDA BALL
Counselor (Addiction (Substance Use Disorder))
1011 MAIN ST
COLUMBUS, MS 39701
Lowndes County (662) 327-7916
MELISSA COOPER LCSW
Social Worker (Clinical)
1011 MAIN ST
COLUMBUS, MS 39701
Lowndes County (662) 327-7916
AUDIE DAUBER
Counselor (Addiction (Substance Use Disorder))
1011 MAIN ST
COLUMBUS, MS 39701
Lowndes County (662) 327-7916
PETE CARR
Counselor (Addiction (Substance Use Disorder))
1011 MAIN ST
COLUMBUS, MS 39701
Lowndes County (662) 327-7916
BERRELL L COBB
Counselor (Addiction (Substance Use Disorder))
1011 MAIN ST
COLUMBUS, MS 39701
Lowndes County (662) 327-7916
CANDACE WALSH
Counselor (Addiction (Substance Use Disorder))
1011 MAIN ST
COLUMBUS, MS 39701
Lowndes County (662) 327-7916

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Keenyn Wald's NPI number?

The NPI number for Keenyn Wald is 1710598255. It was assigned to this individual provider in the NPPES registry on August 10, 2020.

Where is Keenyn Wald located?

Keenyn Wald practices at 1011 Main St, Columbus, MS 39701. The listed phone number is (662) 327-7916.

What is Keenyn Wald's specialty?

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

Is Keenyn Wald enrolled in Medicare?

Yes. Keenyn Wald is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Keenyn Wald was last updated on October 15, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.