Keely Johnson, PSY.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1418 Issued in OK

Practice address

2529 S Kelly Ave Ste B
Edmond, OK 73013-2976

Phone

(405) 454-8016

Fax

(405) 583-4963

NPI assigned

Oct 18, 2022

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

• Keely Rae Johnson Heiderstadt Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Wildflower Psychology and Consulting, LLC

  • Clinical Psychologist
  • Edmond, OK
  • NPI 1326850629
  NPD Authorized official
• Well Within Counseling Center

  • Mental Health Counselor
  • Virginia Beach, VA
  • NPI 1134012487
  NPD

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

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779148800000",
    "number": "1154047314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2529 S KELLY AVE STE B",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730132976",
            "telephone_number": "405-454-8016",
            "fax_number": "405-583-4963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2529 S KELLY AVE STE B",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730132976",
            "telephone_number": "405-454-8016",
            "fax_number": "405-583-4963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KEELY",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-18",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OK",
            "license": "1418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEELY RAE",
            "last_name": "HEIDERSTADT",
            "middle_name": "JOHNSON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jaci Elizabeth Johnson
• Jacqueline R Johnson
• Jerimiah Johnson, M.D.
• Jo Ellen Johnson
• Karmella Johnson, OTA
• Kimberly Michelle Johnson
• Leah Grace Johnson
• Liane Sylvia Johnson, RBT
• Lindy Megan Green Johnson, LCSW
• Madison Reide Johnson, AU.D

• Clinical Psychologist in Edmond, OK
• Providers in Edmond, OK by specialty
• Clinical Psychologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2026; 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.