Killebrew Psychological Services, Llc | |
133 Berry Ln Madison MS 39110-8616 | |
(601) 750-6102 | |
Not Available |
Full Name | Killebrew Psychological Services, Llc |
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Speciality | Psychologist |
Location | 133 Berry Ln, Madison, Mississippi |
Authorized Official Name and Position | Alyssa E. Killebrew (CLINICAL PSYCHOLOGIST) |
Authorized Official Contact | 6017506102 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Killebrew Psychological Services, Llc 133 Berry Ln Madison MS 39110-8616 Ph: (601) 750-6102 | Killebrew Psychological Services, Llc 133 Berry Ln Madison MS 39110-8616 Ph: (601) 750-6102 |
NPI Number | 1073988051 |
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Provider Enumeration Date | 12/02/2015 |
Last Update Date | 02/03/2022 |
Certification Date | 02/03/2022 |
Medicare PECOS PAC ID | 8426330226 |
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Medicare Enrollment ID | O20170130002648 |
Identifier | Type | State | Issuer |
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1073988051 | NPI | - | NPPES |
Provider Name | Alyssa E Killebrew |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1306130125 PECOS PAC ID: 1052633294 Enrollment ID: I20141125001874 |
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