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Deactivated NPI 1487786380 Deactivated / Inactive NPI Male Practitioner

Dr. William C. Kellermann , PhD, LPC

Counselor - Professional • Washington, MO

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. William Kellermann has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date March 09, 2007
NPI Deactivation Date July 17, 2025
Total Practice Duration ~18 Years of Practice (2007 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. William Kellermann, PhD, LPC was a registered Counselor - Professional practicing in Washington, MO. Throughout an active medical career spanning 18 years, Dr. Kellermann provided care at the practice location at 475 KRAKOW RIDGE LN until profile deactivation on 2025-07-17.

Practice Location & Contact Primary Location

Practice Address

475 Krakow Ridge Ln

Washington, MO 630906267

Telephone 6363902971
Fax 6363900597

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Washington, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 11.5 Yrs
State Avg: 13.5 Yrs
Regional Practice Density
13 Specialists

Practicing in Washington, MO (5929 Statewide)

Telehealth Adoption Rate
7.7% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License MO 2002014138

Definition to come...

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated July 17, 2025

Record deactivated on July 17, 2025

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 475 KRAKOW RIDGE LN, WASHINGTON, MO 630906267 (Tel: 6363902971)

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Updated Business Mailing Address July 08, 2007

Registered at 475 KRAKOW RIDGE LN, WASHINGTON, MO 630906267 (Tel: 6363902971)

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Provider Name / Credentials Updated July 08, 2007

Recorded as WILLIAM KELLERMANN, PHD, LPC

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Counselor (License #2002014138 in MO)

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Initial NPI Registration & Enumeration March 09, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1487786380
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 09, 2007
Last Update: July 08, 2007
Deactivation Date: July 17, 2025

Mailing Address

475 Krakow Ridge Ln

Washington, MO 630906267

Phone: 6363902971

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

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