Jeane, Martin Keller
Jeane, Martin Keller is an sole proprietor health care provider with primary practice located at 305 Regency Parkway #601, Mansfield TX 76063-7306. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Jeane, Martin Keller can be contacted via phone (817) 539-0499.Contact Information
Primary practice address
305 Regency Parkway #601
Mansfield TX 76063-7306
Phone: (817) 539-0499
Fax: (817) 539-0498
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 08035 | Texas |
| Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X | 116 | Texas |
Profile Details
| NPI number | 1790863355 |
|---|---|
| LBN Legal business name | Jeane, Martin Keller |
| Credentials | PH.D., LPC-S, LMFT |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 1st, 2006 |
| Last updated | Aug 26th, 2026 - about 2 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790863355 | NPPES |
| Texas | Other | 052194000 | MAGELLAN PROV ID |
| Texas | Other | 1017LC | MAGELLAN PROV ID |
| Texas | MEDICAID | 025581201 | MAGELLAN PROV ID |
| Texas | Other | 128615 | MAGELLAN PROV ID |
| Texas | Other | 10029868 | MAGELLAN PROV ID |
| Texas | Other | 143906 | MAGELLAN PROV ID |
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