DR. WALT KELLER (NPI# 1891052908) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891052908 |
| Entity Type | Individual |
| Full Name | DR. WALT KELLER |
| Credential | HSPP |
| Practice Address |
645 N Walnut St Bloomington IN 47404-3846 |
| Mailing Address |
Po Box 11 Bloomington IN 47402-0011 |
| Practice Telephone | 8123363570 |
| Practice Fax Number | 8123369010 |
| Mailing Telephone | 8123363570 |
| Mailing Fax Number | 8123369010 |
| Enumeration Date | 2012-04-13 |
| Last Update Date | 2012-04-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
20040042 | IN | Behavioral Health & Social Service Providers |
| Street Address |
645 N WALNUT ST |
| City | BLOOMINGTON |
| State | IN |
| Zip Code | 47404-3846 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760503718 | Mark Delong | Counselor | 645 N Walnut St, Bloomington, IN 47404-3846 | 2007-04-03 |
| 1669931341 | Amanda Adhami | Psychologist | 645 N Walnut St, Bloomington, IN 47404-3846 | 2019-03-13 |
| 1710432851 | James Flannery Walker | Social Worker | 645 N Walnut St, Bloomington, IN 47404-3846 | 2016-08-18 |
| 1699127886 | Desirae Deniece Draluck | Counselor | 645 N Walnut St, Bloomington, IN 47404-3846 | 2016-07-12 |
| 1154776680 | Andrea Cheek | Social Worker | 645 N Walnut St, Bloomington, IN 47404-3846 | 2016-05-03 |
| 1235505876 | Kaitlin King | Social Worker | 645 N Walnut St, Bloomington, IN 47404-3846 | 2015-08-18 |
| 1447626080 | Shelby Robertson | Social Worker | 645 N Walnut St, Bloomington, IN 47404-3846 | 2015-08-18 |
| 1578939641 | Maria Roncalli | Counselor | 645 N Walnut St, Bloomington, IN 47404-3846 | 2015-08-12 |
| 1053744474 | Amethyst House | Social Worker | 645 N Walnut St, Bloomington, IN 47404-3846 | 2013-08-21 |
| 1588865505 | Thomas W Cox | Counselor | 645 N Walnut St, Bloomington, IN 47404-3846 | 2007-05-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013526631 | Sandra Clark | Counselor | 205 N College Avenue, Suite 210a, Bloomington, IN 47404 | 2020-07-29 |
| 1750926085 | Michelle Christine Dustin | Nurse Practitioner | 610 N Morton Street, Bloomigton, IN 47404 | 2019-11-11 |
| 1316440191 | Julie D'argent | Psychologist | 205 N College Ave Ste 430, Bloomington, IN 47404 | 2018-03-17 |
| 1770966467 | Richard Lawson | Counselor | 1117 North Jackson Street, Bloomington, IN 47404 | 2015-06-30 |
| 1477952109 | Teresa R. Foster | Social Worker | 205 N. College Avenue, Suite 210b, Bloomington, IN 47404 | 2014-08-19 |
| 1073879532 | First Health Plus, Inc | Clinic/Center | 104 North Curry Pike, Bloomington, IN 47404 | 2012-04-09 |
| 1497079982 | Tera Dee Nance | Counselor | 101 W. Kirkwood Avenue, Suite 009 Fountain Square Mall, Bloomington, IN 47404 | 2010-03-26 |
| 1962643114 | Pathways Counseling Center | Community/Behavioral Health | 3866 W. Third Street, Bloomington, IN 47404 | 2009-03-18 |
| 1932358595 | Catherine Elizabeth Batka | Psychologist | 101 W. Kirkwood Ave, Suite 103, Bloomington, IN 47404 | 2008-09-18 |
| 1396901005 | Kijin Woo | Dentist | 330 N Jacob Drive, Bloomington, IN 47404 | 2008-08-01 |
| Find all providers in zip 47404 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154885028 | Sara J. W. Biebl, Ph.d., Licensed Psychologist, Pllc | Psychologist | 7900 Xerxes Ave S Ste 1125, Bloomington, MN 55431-1112 | 2019-01-24 |
| 1053894501 | Thrive Psychology Services, LLC | Psychologist | 4120 W Dresden Dr, Bloomington, IN 47404-8403 | 2018-09-11 |
| 1194184465 | Chjl LLC | Psychologist | 8120 Penn Ave S Ste 252, Bloomington, MN 55431-1358 | 2016-02-16 |
| 1992100077 | Lindeman and Associates, LLC | Psychologist | 3802 E 3rd St, Suite 220, Bloomington, IN 47401-5504 | 2014-10-30 |
| 1255772174 | Amanda Quinby | Psychologist | 205 N College Ave Ste 512, Bloomington, IN 47404-3952 | 2013-07-08 |
| 1457609802 | Jason Vasquez | Psychologist | 2416 Washington, A-3, Bloomington, IL 61704 | 2012-08-16 |
| 1710282058 | Annorah Sheeran Moorman | Psychologist | 1319 Fell Ave, Bloomington, IL 61701-1828 | 2011-01-18 |
| 1477860609 | Hoffmann Burchett Psychological Services, LLC | Psychologist | 205 N Williamsburg Dr, Suite F, Bloomington, IL 61704-7706 | 2010-09-09 |
| 1356654693 | James Wiltz | Psychologist | 2745 E Elderberry Ct, Bloomington, IN 47401-4307 | 2010-07-15 |
| 1528207784 | Jennifer Elizabeth Koch | Psychologist | 2502 E Empire St Ste C, Bloomington, IL 61704-3739 | 2009-02-11 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 47404 |
Please comment or provide details below to improve the information on DR. WALT KELLER.
| 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.