Nicole Kelly, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

38980 Issued in TX

Practice address

21915 Citrus Grove CT
Cypress, TX 77433-9936

Phone

(562) 704-8468

NPI assigned

Feb 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Darrell Broaddus Psychological Services PC

  • Clinical Psychologist
  • Orangevale, CA
  • NPI 1215339650
  NPD (past)

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790294400000",
    "number": "1356482475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3225 MCLEOD DR STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891212257",
            "telephone_number": "562-704-8468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21915 CITRUS GROVE CT",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774339936",
            "telephone_number": "562-704-8468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "NICOLE",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2026-09-25",
        "certification_date": "2026-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KS",
            "license": "03570",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "38980",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "24468",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chukwudiebere Keke
• Harold Richard Keller, LCSW
• Kayla Ann Keller, LCSW
• Kelly Counsels Incorporated (Kelly Counsels Inc.)
• Connie L.M. Kelly, LPC
• Kelm Wellness Evolution LLC
• Amanda Kelso
• Kendall Health Care
• Lori Bender Kennedy, LMT, MMP
• Mikhayla D Kent, RBT

• Clinical Psychologist in Cypress, TX
• Providers in Cypress, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.