Provider Demographics
NPI:1902229222
Name:ZEABART, KELLE (LCSW)
Entity Type:Individual
Prefix:
First Name:KELLE
Middle Name:
Last Name:ZEABART
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KELLE
Other - Middle Name:
Other - Last Name:BECKHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:240 N TILLOTSON AVE
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-3988
Mailing Address - Country:US
Mailing Address - Phone:765-288-1928
Mailing Address - Fax:765-741-0335
Practice Address - Street 1:120 W MCKENZIE RD STE F
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:IN
Practice Address - Zip Code:46140
Practice Address - Country:US
Practice Address - Phone:317-468-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-22
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34006888A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical