MS. CHARMAINE W KELLER (,LICSW,LCSW, CAP) – Clinical Social Worker, NPI 1417078064
Clinical Social Worker
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MS. CHARMAINE W KELLER (,LICSW,LCSW, CAP)
1225 1/2 11th St N
Saint Petersburg, FL 337051042
Phone: (727) 481-3581
Fax: (603) 413-4848
Type: Location
2730 CENTRAL AVE
ST PETERSBURG, FL 337121153
Phone: (727) 481-3581
Fax: (727) 327-3759
Type: Mailing
145 Pine Haven Shores Rd Ste 1000A
Shelburne, VT 054827812
Phone: (727) 481-3581
Fax: (603) 413-4848
Type: Location
15 PARK ST UNIT 101
NEWPORT, NH 037738038
Phone: (727) 481-3581
Fax: (603) 413-4848
Type: Mailing
24 OPERA HOUSE SQ # 409
CLAREMONT, NH 037435408
Phone: (727) 481-3581
Fax: (603) 413-4848
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-11-18
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20110928000552 | I | Clinical Social Worker | FL | TBD |
| I20191028000901 | I | Clinical Social Worker | VT | TBD |
| I20191118001286 | I | Clinical Social Worker | NH | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 33705)
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