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NPI Code Detail

MEDICARE: DANIELLE KELLER LICDC

MEDICARE: DANIELLE KELLER LICDC
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
11041C0700XClinical Social Worker0900643OH
2101YA0400XAddiction (Substance Use Disorder) CounselorS0900643OH

General Provider Information

NPI Number : 1497257455
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE KELLER LICDC
Provider Business Mailing Address
First Line : 3200 BURNET AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45229-3019
Country : US
Telephone Number :
Fax Number : 513-585-5511
Provider Business Practice Location Address
First Line : 7162 READING RD STE 900
Second Line :
City : CINCINNATI
State : OH
Zip : 45237-3879
Country : US
Telephone Number : 513-559-3169
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2018
Last Update Date : 02/01/2024

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