Alyssa Ellis Killebrew, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

54946 Issued in MS

Practice address

241 Sunnybrook Rd
Ridgeland, MS 39157-2206

Phone

(601) 624-5912

NPI assigned

Jun 9, 2011

Last updated

Dec 20, 2024By the provider in NPPES

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

• Alyssa E. Killebrew Other name

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Clinical Psychologist

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Killebrew Psychological Services LLCGroup PAC ID 8426330226, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Killebrew Psychological Services, LLC

  • Psychologist
  • Ridgeland, MS
  • NPI 1073988051
  Medicare reassignment Care Compare group Authorized official
• Essential Touchtones

  • Clinical Psychologist
  • Ridgeland, MS
  • NPI 1730663469
  NPD Authorized official

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

{
    "created_epoch": "1307577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1306130125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W JACKSON ST",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391572312",
            "telephone_number": "601-750-6102",
            "fax_number": "601-707-7291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 SUNNYBROOK RD",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391572206",
            "telephone_number": "601-624-5912"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "133 Berry Ln",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "MS",
            "postal_code": "391108616",
            "country_code": "US",
            "telephone_number": "601-750-6102",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "210 W Jackson St",
            "address_purpose": "LOCATION",
            "city": "Ridgeland",
            "state": "MS",
            "postal_code": "391572312",
            "country_code": "US",
            "telephone_number": "601-750-6102",
            "fax_number": "601-707-7291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILLEBREW",
        "first_name": "ALYSSA",
        "middle_name": "ELLIS",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-09",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MS",
            "license": "54946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "KILLEBREW",
            "middle_name": "E.",
            "credential": "PHD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Laurel Elizabeth Kett, MS, LMFT
• Jaida Key
• Lenora Keys, RN
• Avani Hiralal Khatri, DDS
• Killebrew Psychological Services, LLC
• Michelle T Killebrew, PT
• John Michael Kimbriel, LPTA
• Jennifer Kimbrough
• Maggie Kimler
• Kinetix Group LLC

• Clinical Psychologist in Ridgeland, MS
• Providers in Ridgeland, MS by specialty
• Clinical Psychologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.