Kellie Byrd, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

171487 Issued in KY

Practice address

2817 Rock Merritt Ave
Fort Bragg, NC 28310-7394

Phone

(910) 570-3444

NPI assigned

Aug 19, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kellie Denise Fish Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1629331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1134895113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4513 MICKLENBURG CT",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402451866",
            "telephone_number": "843-450-3843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVE",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283107394",
            "telephone_number": "910-570-3444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYRD",
        "first_name": "KELLIE",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-19",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "171487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLIE",
            "last_name": "FISH",
            "middle_name": "DENISE",
            "credential": "PSYD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brandy Marie Butler, M.D.
• Melissa Butler, PH.D.
• Michael Martin Butler, PH.D.
• Sara A Butler, DPT
• Thomas Richard Butler, PAC
• Jessica Byrne, DMD
• Ashley Byron, OTR/L
• Michael Francis Cabaj, PHARMD
• Aileen Resurreccion Cabanada-Logan, DMD
• Tara Louise Caberwal, DPT

• Clinical Psychologist in Fort Bragg, NC
• Providers in Fort Bragg, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.