Active NPI
Roberta D Celaya, PLP
- Clinical Psychologist
- Springfield, MO
National Provider Identifier
1013743541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2024041716
- Practice address
- 1350 E Bradford Pkwy
Springfield, MO 65804-4376 - Phone
- (417) 761-5000
- NPI assigned
- Sep 11, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2024041716 | MO | Primary |
Addresses
Primary practice location
1350 E Bradford Pkwy
Springfield, MO 65804-4376
Mailing address
PO Box 844715
Kansas City, MO 64184-4715
Phone (417) 761-5214
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2024041716 | MO | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728950400000",
"number": "1013743541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 844715",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641844715",
"telephone_number": "417-761-5214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 E BRADFORD PKWY",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658044376",
"telephone_number": "417-761-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CELAYA",
"first_name": "ROBERTA",
"middle_name": "D",
"credential": "PLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-11",
"last_updated": "2024-10-15",
"certification_date": "2024-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MO",
"license": "2024041716",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.