| Jim R. Keller, Ph.d., Specialists In Psychological Counseling & Consul | |
|
1800 Renaissance Blvd 2nd Floor Edmond OK 73013-3023 | |
| (405) 359-2481 | |
| (405) 359-2487 |
| Full Name | Jim R. Keller, Ph.d., Specialists In Psychological Counseling & Consul |
|---|---|
| Speciality | Psychologist |
| Location | 1800 Renaissance Blvd, Edmond, Oklahoma |
| Authorized Official Name and Position | James Riley Keller (OWNER, PSYCHOLOGIST) |
| Authorized Official Contact | 4053592481 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jim R. Keller, Ph.d., Specialists In Psychological Counseling & Consul Po Box 7083 Edmond OK 73083-7083 Ph: (405) 359-2481 | Jim R. Keller, Ph.d., Specialists In Psychological Counseling & Consul 1800 Renaissance Blvd 2nd Floor Edmond OK 73013-3023 Ph: (405) 359-2481 |
| NPI Number | 1225260565 |
|---|---|
| Provider Enumeration Date | 08/20/2009 |
| Last Update Date | 04/01/2021 |
| Certification Date | 04/01/2021 |
| Medicare PECOS PAC ID | 8820136765 |
|---|---|
| Medicare Enrollment ID | O20091112000555 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225260565 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | 854 (Oklahoma) | Primary |
| Provider Name | James R Keller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437340528 PECOS PAC ID: 5698813533 Enrollment ID: I20091112000496 |
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