Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Matthew Ryan Keller, MSW, LICSW

Individual provider Clinical Social Worker · NPI 1336664614

Matthew Ryan Keller, MSW, LICSW is a Clinical Social Worker in Crookston, Minnesota. Qualified in 2014, 12 years ago. Practices with Center for Self-Growth and Renewal, PC, a 4-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
12
Licensed in
MN
In the registry since
2017
What do these letters mean?
MSW — Master of Social Work
The graduate degree in social work.
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

603 Bruce St
Crookston, MN 56716-2914
Phone: (218) 281-3940
Fax: (218) 281-6261
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 24371 (MN)

Record details

NPI number1336664614
Entity typeIndividual (Type 1)
GenderMale
Credentials MSW , LICSW
Sole proprietorNo
NPI enumeratedAugust 8, 2017
Last updated in NPPESJuly 21, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Center For Self-Growth And Renewal, Pc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Crookston