Luma Psychology PLLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

LUMA PSYCHOLOGY PLLC

Doing business as

Theresa Kellam, Ph.D. Licensed Psychologist

Practice address

2201 Dottie Lynn Pkwy Ste 127
Fort Worth, TX 76120-4435

Phone

(817) 313-7899

NPI assigned

Nov 14, 2019

Last updated

Nov 14, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Theresa Kellam, PHDNPI 1841271772

Title

Owner/Psychologist

Phone

(817) 313-7899

Specialties & licenses 1

Addresses

Other names 1

• Theresa Kellam, Ph.D. Licensed Psychologist Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Theresa Kellam, PSYCHOLOGIST

  • Psychologist
  • Fort Worth, TX
  • NPI 1841271772
  NPD Authorized official

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

{
    "created_epoch": "1573689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573689600000",
    "number": "1306481205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 DOTTIE LYNN PKWY STE 127",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761204435",
            "telephone_number": "817-313-7899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 DOTTIE LYNN PKWY STE 127",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761204435",
            "telephone_number": "817-313-7899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMA PSYCHOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-14",
        "last_updated": "2019-11-14",
        "status": "A",
        "authorized_official_last_name": "KELLAM",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "OWNER/PSYCHOLOGIST",
        "authorized_official_telephone_number": "817-313-7899",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Theresa Kellam, Ph.D. Licensed Psychologist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Luis Abel Lujan
• Linda K Lukas, CNS
• Rebecca Repasky Luke, D.O.
• Serena Luke
• Luli Compassion LLC
• Allante Lumas
• Lumin ER Camp Bowie LLC
• Luminary Hospice of Fort Worth, LLC (Luminary Hospice)
• Luminex Scope LLC
• Lumos Integrative Psychiatry and Wellness, PLLC

• Psychologist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2019; 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.