Lia R Kettenis
M.D. | Psychiatry | Child & Adolescent | 23+ years Exp
645 S Rogers St, Bloomington
Indiana, 47403-2353
812-269-5092 Maps & DirectionsLia R Kettenis is a Bloomington, Indiana based psychiatrist with 23 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: | 23+ 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.
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 October, 2025.