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KEELY IMBODEN
NPI 1962157487
Counselor - Professional in Harrisburg, AR

Active since February 14, 2022PECOS Enrolled
1103 N ILLINOIS ST STE B, HARRISBURG, AR 72432(870) 931-8412 Get Directions Write a Review

NPPES record last updated: May 20, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 20, 2025, May 16, 2025, Oct 25, 2022 and 1 more (4 updates tracked since 2022).

About Keely Imboden NPPES

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

KEELY IMBODEN (NPI 1962157487) is an individual professional provider in Harrisburg, Arkansas and active in the NPI registry since February 2022. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1962157487
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameKEELY IMBODEN
Location Address1103 N ILLINOIS ST STE BHarrisburg, AR 72432-3023
Mailing Address1103 N Illinois St Ste BHarrisburg, AR 72432-3023 · (870) 931-8412
Phone(870) 931-8412
Sole ProprietorYes
Enumeration DateFebruary 14, 2022
Last NPPES UpdateMay 20, 20254 updates tracked since enumeration
NPPES CertifiedMay 20, 2025
✔ NPI 1962157487 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License A2208025 (AR)
Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X
1103 N ILLINOIS ST STE B, Harrisburg, AR 72432
Open in Google Maps ↗

Other Names 1

Former Name (1)Keely Maynard

Secondary Practice Locations 2

Location 1204 Mississippi St SWynne, AR 72396-3025 · Phone (870) 208-8499
Location 22707 Browns LnJonesboro, AR 72401-7213 · Phone (870) 972-4050

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Keely Imboden 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.

Medicare Billing Reassignment

Medicare enrollment records show Keely Imboden reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Changes Behavioral Health, LLC
25 mi
Community/Behavioral Health
204 MISSISSIPPI ST S
Wynne, AR 72396
  • Reassigned Medicare billing, Arkansas enrollment
  • 26 clinicians in this Medicare group
NPI 1114260486 (870) 208-8499

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES

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

1821 COUNSELING LLC
Counselor (Professional)
1103 N ILLINOIS ST STE B
HARRISBURG, AR 72432
Poinsett County (870) 931-8412

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 Keely Imboden's NPI number?

The NPI number for Keely Imboden is 1962157487. It was assigned to this individual provider in the NPPES registry on February 14, 2022. The provider is also known as Keely Maynard.

Where is Keely Imboden located?

Keely Imboden practices at 1103 N Illinois St Ste B, Harrisburg, AR 72432. The listed phone number is (870) 931-8412.

What is Keely Imboden's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Keely Imboden enrolled in Medicare?

Yes. Keely Imboden is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Keely Imboden's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Keely Imboden reassigns Medicare benefits to Changes Behavioral Health, LLC (Wynne, AR). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Keely Imboden's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Keely Imboden accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 3 other insurers list Keely Imboden as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Keely Imboden was last updated on May 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.