Individual provider

KILLEBREW PSYCHOLOGICAL SERVICES, LLC

Psychologist Community/Behavioral Health Agency Health Maintenance Organization Deactivated record

KILLEBREW PSYCHOLOGICAL SERVICES, LLC is a Psychologist in Ridgeland, MS, registered under NPI 1073988051. This provider registers 3 separate taxonomy codes, which usually means they practise across more than one recognised specialty.

This NPI is deactivated. The provider has retired, changed registration, or the number was retired by CMS. Details below are kept for reference — do not rely on them to arrange care.

Getting there

The practice address on file is 241 SUNNYBROOK RD, Ridgeland, MS 39157. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

241 SUNNYBROOK RD, Ridgeland, MS 39157 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
54946 MS Psychologist primary
54946 MS Community/Behavioral Health Agency
54946 MS Health Maintenance Organization

This provider holds licence 54946 issued in MS. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.

Medicare (PECOS)
Status
Approved
Provider type
Part B Supplier - Clinic/group Practice
PAC ID
8426330226
Enrollment ID
O20170130002648

Medicare enrolment is recorded as approved under the provider type Part B Supplier - Clinic/group Practice. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

What Psychologist covers

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. NUCC Health Care Provider Taxonomy, code 103T00000X
Behavioral Health & Social Service Providers Psychologist

All registered taxonomy codes

This provider registers 3 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
103T00000X Psychologist 54946 MS primary
251S00000X Community/Behavioral Health Agency 54946 MS
302R00000X Health Maintenance Organization 54946 MS

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1073988051 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateDec 2, 2015
Last updatedNov 19, 2024
StatusDeactivated
Sole proprietorNo
Practice address 241 SUNNYBROOK RD
Ridgeland, MS 39157
(769) 231-9414
Mailing address 133 BERRY LN
Madison, MS 39110
This record was updated on Nov 19, 2024, which is recent enough that the contact details are likely still accurate.

Number check

1073988051 passes the NPI check digit test The final digit 1 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 0 7 3 9 8 8 0 5
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 0 5 3 9 8 7 0 1

Sum = 59 · next multiple of 10 = 60 · check digit = 1 · actual last digit = 1

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1073988051?
NPI 1073988051 is the National Provider Identifier assigned to KILLEBREW PSYCHOLOGICAL SERVICES, LLC in Ridgeland, MS. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Psychologist cover?
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…
How do I contact KILLEBREW PSYCHOLOGICAL SERVICES, LLC?
The phone number on file with NPPES is (769) 231-9414, last updated Nov 19, 2024. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does KILLEBREW PSYCHOLOGICAL SERVICES, LLC accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1073988051 a valid number?
Yes. 1073988051 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.