Individual provider Active NPI

Kelly L Hunter, PSYD

  • Psychologist
  • Fort Worth, TX
National Provider Identifier
1114170305
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
38496 Issued in TX
Practice address
1300 S University Dr Ste 306
Fort Worth, TX 76107-5746
Phone
(844) 824-8775
Fax
(281) 648-2200
NPI assigned
Oct 31, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 38496 TX Primary

Addresses

Primary practice location

1300 S University Dr Ste 306
Fort Worth, TX 76107-5746

Mailing address

12132 Bella Palazzo Dr
Fort Worth, TX 76126-2134
Phone (817) 301-3621

Other identifiers 3

IdentifierTypeStateIssuer
201651101MedicaidTX
87968AOtherTXBCBS
P00998015OtherTXRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090514000441 TX Practitioner - Clinical Psychologist 1658420005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Progressive Behavioral Health, PLLCGroup PAC ID 4486794906, 366 clinicians

Practice addresses (Care Compare)

1300 S University Dr
Suite 306
Fort Worth, TX 76107-5746
Phone (844) 824-8775

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38496TXMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Behavioral Health, PLLC CurrentSince Mar 21, 2025 Accepting new patients

Locations

1300 S University Dr
Ste 306
Ft Worth, TX 76107
Phone (817) 410-7300

431 E State Highway 114
Ste 140
Southlake, TX 76092
Phone (817) 751-7802

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1225411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1114170305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12132 BELLA PALAZZO DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761262134",
            "telephone_number": "817-301-3621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 S UNIVERSITY DR STE 306",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761075746",
            "telephone_number": "844-824-8775",
            "fax_number": "281-648-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNTER",
        "first_name": "KELLY",
        "middle_name": "L",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-31",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "38496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201651101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "87968A",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00998015",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.