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Contact Information

KILLEBREW PSYCHOLOGICAL SERVICES, LLC
241 SUNNYBROOK RD
RIDGELAND, MS39157-2206
 Phone: 769-231-9414
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
 

Community/Behavioral Health

251S00000X
 

Health Maintenance Organization

302R00000X
Indicates primary specialty

NPI Profile & details for KILLEBREW PSYCHOLOGICAL SERVICES, LLC

NPI # 1073988051
LBN Legal business name KILLEBREW PSYCHOLOGICAL SERVICES, LLC
Authorized official ALYSSA KILLEBREW - (CLINICAL PSYCHOLOGIST)
Entity Organization
Organization subpart 1 No
Enumeration date 12/02/2015
Last updated 11/19/2024 - More than a year ago
Identifiers
MS License # 54946
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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