KILLEBREW PSYCHOLOGICAL SERVICES, LLC (NPI# 1073988051) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073988051 |
| Entity Type | Organization |
| Organization Name | KILLEBREW PSYCHOLOGICAL SERVICES, LLC |
| Practice Address |
133 Berry Ln Madison MS 39110-8616 |
| Practice Telephone | 6017506102 |
| Mailing Telephone | 6017506102 |
| Enumeration Date | 2015-12-02 |
| Last Update Date | 2015-12-02 |
| Authorized Official Name | DR. ALYSSA E. KILLEBREW (CLINICAL PSYCHOLOGIST) |
| Authorized Official Telephone | 6017506102 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | 54946 | MS | Agencies |
| N | 302R00000X | Health Maintenance Organization | 54946 | MS | Managed Care Organizations |
| Y | 103T00000X | Psychologist | 54946 | MS | Behavioral Health & Social Service Providers |
| Street Address |
133 BERRY LN |
| City | MADISON |
| State | MS |
| Zip Code | 39110-8616 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134784689 | Therapy South - Gluckstadt LLC | Physical Therapist | 1716 Us 51, Ste N, Madison, MS 39110 | 2019-05-09 |
| 1871054098 | Summit Medical Solutions | Durable Medical Equipment & Medical Supplies | 107 Azalea Street, Madison, MS 39110 | 2019-03-29 |
| 1912488198 | Madison Medical Compounding Pharmacy | Pharmacy | 111 Fountains Blvd. Building B Ste. A, Madison, MS 39110 | 2018-08-24 |
| 1679061469 | Nuvena Vein Clinic | Anesthesiology | 120 Fountains Blvd, Madison, MS 39110 | 2018-04-26 |
| 1467960484 | Brick City Drugs, LLC | Durable Medical Equipment & Medical Supplies | 159 Fountains Blvd, Madison, MS 39110 | 2018-01-11 |
| 1093227589 | Hannah Monk Hawthorne | Counselor | 930 Ebenezer Blvd., Suite D, Madisin, MS 39110 | 2017-10-25 |
| 1548786650 | Kimberly Allen | Pharmacist | 1100 Us- 51, Madison, MS 39110 | 2017-08-21 |
| 1891218186 | Delta Elizabeth Stark | Chiropractor | 1085 Gluckstadt Rd., Bld 300 Ste E, Madison, MS 39110 | 2017-07-19 |
| 1861914848 | Laura Hartlein | Dietitian, Registered | 200 Park Circle Dr. #2, Flowood, MS 39110 | 2017-07-12 |
| 1831620608 | Ona Irby | Occupational Therapist | 105 Munich Dr, Madison, MS 39110 | 2017-03-23 |
| Find all providers in zip 39110 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073138327 | Rachel Kahn | Psychologist | 501 Acacia Ln, Madison, WI 53716-3238 | 2020-06-12 |
| 1700363652 | Capital City Psychology, LLC | Psychologist | 313 Price Pl Ste 210, Madison, WI 53705-3262 | 2018-07-24 |
| 1093222010 | Leya Moore | Psychologist | 1415 Rutledge St, Madison, WI 53703-3834 | 2017-12-29 |
| 1306359591 | Elizabeth Gaebler | Psychologist | 700 Ray O Vac Dr Ste 114, Madison, WI 53711-2468 | 2017-11-09 |
| 1619489135 | Streicher-bremer Psychotherapy Sc | Psychologist | 1619 Monroe St Ste 2, Madison, WI 53711-2063 | 2017-10-25 |
| 1356736565 | Madison Behavioral Psychology, LLC | Psychologist | 7818 Big Sky Dr Ste 210, Madison, WI 53719-3524 | 2015-04-03 |
| 1457756595 | Familypath Autism Services, LLC | Psychologist | 575 Donofrio Dr Ste 101, Madison, WI 53719-2832 | 2014-10-31 |
| 1104184142 | Hurd Counseling and Educational Psychology | Psychologist | 700 Rayovac Drive, Madison, WI 53711 | 2012-04-27 |
| 1679865992 | Sharon Kelley | Psychologist | 1213 N. Sherman Ave, Suite 334, Madison, WI 53704 | 2011-05-04 |
| 1225342280 | Daniel P. Davis | Psychologist | 7601 Ganser Way, 2nd Floor Suite, Madison, WI 53719-2074 | 2010-08-02 |
| Find all providers in MADISON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.