KIMLY KEETON (NPI# 1548650930) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548650930 |
| Entity Type | Individual |
| Full Name | KIMLY KEETON |
| Credential | LCSW, LCAC |
| Practice Address |
809 Jefferson Ave La Porte IN 46350-3431 |
| Mailing Address |
2725 Beauty Creek Run Valparaiso IN 46385-7049 |
| Practice Telephone | 2198985646 |
| Mailing Telephone | 2197418895 |
| Enumeration Date | 2015-01-23 |
| Last Update Date | 2016-03-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
87001395A | IN | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
34006482A | IN | Behavioral Health & Social Service Providers |
| Street Address |
809 JEFFERSON AVE |
| City | LA PORTE |
| State | IN |
| Zip Code | 46350-3431 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972592798 | Thomas M Allen | Psychologist | 809 Jefferson Ave, La Porte, IN 46350-3431 | 2005-10-14 |
| 1114576154 | Tina Marie Pierce | Nurse Practitioner | 809 Jefferson Ave, La Porte, IN 46350-3431 | 2019-09-11 |
| 1194064568 | Deana Sherbondy | Counselor | 809 Jefferson Ave, La Porte, IN 46350-3431 | 2013-02-05 |
| 1750627253 | Cynthia White | Marriage & Family Therapist | 809 Jefferson Ave, La Porte, IN 46350-3431 | 2013-01-02 |
| 1306171202 | Renee Lewis | Counselor | 809 Jefferson Ave, La Porte, IN 46350-3431 | 2009-10-09 |
| 1285686634 | Rachael Manney | Social Worker | 809 Jefferson Ave, La Porte, IN 46350-3431 | 2006-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871139246 | Carolyn Ann Perra | Pharmacist | 55 Pine Lake S.c., Laporte, IN 46350 | 2019-11-20 |
| 1306496492 | Trinity Healthcare Inc. | Occupational Therapist | 2002 Andrew Avenue, Laporte, IN 46350 | 2019-09-19 |
| 1184136665 | Diane Margaret Rich | Physical Therapist | 1643 S Willow Bend Dr, La Porte, IN 46350 | 2017-10-24 |
| 1114460102 | Judith Marie Fitzhugh | Dietitian, Registered | 1775 S. Basswood Trail, Laporte, IN 46350 | 2016-11-23 |
| 1568916971 | Total Renal Care, Inc. | Clinic/Center | 1406 E Lincolnway, Ste A, La Porte, IN 46350 | 2016-08-15 |
| 1083079008 | Irene Torres | Nurse Practitioner | 1407 Lincolnway, La Porte, IN 46350 | 2015-12-17 |
| 1124422910 | Becky Alwood-wallace | Occupational Therapist | 1203 Washington Street, Iu Health La Porte Hospital Wellness & Rehabilitation, La Porte, IN 46350 | 2014-10-22 |
| 1881001527 | Johnson Memorial Hospital | Skilled Nursing Facility | 3530 Monroe Street, La Porte, IN 46350 | 2014-07-15 |
| 1306268941 | Tiffany Anne Satterfield | Physical Therapy Assistant | 194 S 400 E, Laporte, IN 46350 | 2014-01-16 |
| 1801122239 | Mary Barbara Backer | Internal Medicine | 301 Willow Bend Dr, La Porte, IN 46350 | 2009-10-20 |
| Find all providers in zip 46350 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821440546 | Alexis Tatel | Social Worker | 1101 Boyd Blvd, La Porte, IN 46350-4424 | 2016-07-06 |
| 1114162096 | Rhonda Rostecki | Social Worker | 3876 N 625 W, La Porte, IN 46350 | 2008-12-08 |
| 1457540726 | Debra Jane Leroy | Social Worker | 1730 E Lincolnway, La Porte, IN 46350 | 2007-10-23 |
| 1083646392 | Robin Miller | Social Worker | 245 W Johnson Rd, Suite 5, La Porte, IN 46350-2026 | 2006-07-07 |
| 1376186791 | Brittany Betz | Social Worker | 705 Harrison St, La Porte, IN 46350-3417 | 2019-10-18 |
| 1518517929 | Paula Anderson | Social Worker | 705 Harrison St, La Porte, IN 46350-3417 | 2019-09-17 |
| 1447808076 | Denise Doris Grasser | Social Worker | 400 Teegarden St, La Porte, IN 46350-3175 | 2019-08-27 |
| 1770958753 | Silvio Richard Perez | Social Worker | 424 Perry St, La Porte, IN 46350-3200 | 2015-12-02 |
| 1407220999 | Jennifer Ann Martin | Social Worker | 424 Perry St, La Porte, IN 46350-3200 | 2015-11-20 |
| 1104299478 | Cygrid Kristie Perez | Social Worker | 245 W Johnson Rd, Suite 9, La Porte, IN 46350-2026 | 2015-11-08 |
| Find all providers in LA PORTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.