Killebrew Psychological Services, LLC
NPI 1073988051ActiveOrganization· Psychologist· Ridgeland, MS
Psychologist in Ridgeland, Mississippi, registered in NPPES in December 2015. The authorized official on file is Alyssa E. Killebrew, PH.D., Clinical Psychologist. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1073988051 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 2, 2015 |
| Last updated in NPPES | Nov 19, 2024 |
| Certified by provider | Nov 19, 2024 |
| Reactivated | Feb 3, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | 54946 | MS |
| Community/Behavioral Health | 251S00000X | 54946 | MS |
| Health Maintenance Organization | 302R00000X | 54946 | MS |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MS) |
|---|
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