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

Shelly D Keller, LCSW

Individual provider Clinical Social Worker · NPI 1063642700

Shelly D Keller, LCSW is a Clinical Social Worker in Lake Winnebago, Missouri. Qualified in 1998, 28 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
28
Licensed in
MO
In the registry since
2009
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

120 Cherokee Ln
Lake Winnebago, MO 64034-9304
Phone: (816) 623-9711
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 2009014918 (MO)

Record details

NPI number1063642700
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedJuly 15, 2009
Last updated in NPPESJuly 15, 2009

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1998 (28 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare