Lia R Kettenis is a Bloomington, Indiana based psychiatrist with 22 years of experience in Child & Adolescent. She completed her graduation from Washington University School Of Medicine in 2002. She accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Lia R Kettenis is 01063824A for Child & Adolescent in Indiana. Her current practice location is 645 S Rogers St, Bloomington. Patients can reach her at 812-269-5092. Lia R Kettenis is M.D. in Child & Adolescent and her NPI number (Unique professional ID assigned by NPPES) is 1346459146. Lia R Kettenis has done additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
Complete Profile:
Lia R Kettenis speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
Name:
Lia R Kettenis
Specialization:
Child & Adolescent
Gender:
Female
Credentials:
M.D.
Experience:
22+ years
Medical School Attended:
Washington University School Of Medicine
Graduation Year:
2002
Accepts Medicare Assignment:
Yes
Practice Address:
645 S Rogers St, Bloomington, Indiana, 47403-2353
Phone:
812-269-5092
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
PAC ID:
7416041629
Enrollment ID:
I20070919000477
NPI Number:
1346459146
NPI Enumeration Date:
21 May, 2007
NPI Last Update On:
05 Mar, 2024
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Lia R Kettenis are as mentioned below.
License Number
Specialization
State
Status
01063824A
Child & Adolescent
Indiana
Primary
01063824A
Psychiatry
Indiana
Secondary
Hospital Affiliation:
Surgeons are affiliated to many hospitals whom they worked with in the past or are presently working with. One surgeon can be affiliated to four to five hospitals at a time.
Hospital Name (CCN)
State
Hospital Type
(150051)
Bloomington, IN
Acute Care Hospital
Group Practice:
Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name
with which Lia R Kettenis is associated with along with the number of members in that group.
Organization Name (Group PAC ID)
Members
Centerstone Of Indiana, Inc. (9436138427)
47
Other Medical Identifiers:
Other legacy medical identifiers associated with Lia R Kettenis such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
200871370A
Medicaid
Indiana
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Lia R Kettenis 645 S Rogers St, Bloomington, Indiana
Zip:
47403-2353
Phone Number:
812-269-5092
Patients can reach Lia R Kettenis at 645 S Rogers St, Bloomington, Indiana or can call to book an appointment on 812-269-5092.
Comments/ Reviews:
*Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 December, 2024.