Dominik Lia Keller, PHD
NPI 1710627922ActiveIndividual· Psychologist, School· Southaven, MS
Psychologist, School (PHD) in Southaven, Mississippi, licensed in MS, with an NPI issued in March 2022.
Overview
| NPI | 1710627922 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PHD |
| Sole proprietor | No |
| NPI issued | Mar 29, 2022 |
| Last updated in NPPES | Dec 15, 2022 |
| Certified by provider | Dec 15, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, School Primary | 103TS0200X | 621149 | MS |
| Behavior Technician | 106S00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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