MEDICARE: ERIKA K KELLER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LCSW-23724	AZ

General Provider Information

NPI Number	:	1265328132
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIKA K KELLER

Provider Business Mailing Address
First Line	:	409 S LENZNER AVE APT 8103
Second Line	:
City	:	SIERRA VISTA
State	:	AZ
Zip	:	85635-5644
Country	:	US
Telephone Number	:	484-695-0578
Fax Number	:

Provider Business Practice Location Address
First Line	:	197 E FRY BLVD
Second Line	:
City	:	SIERRA VISTA
State	:	AZ
Zip	:	85635-1847
Country	:	US
Telephone Number	:	520-895-0200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2025
Last Update Date	:	04/06/2026

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Directions to “ ERIKA K KELLER ” Practice Location

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