Taban Salem, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

611103 Issued in MS

Practice address

241 Sunnybrook Rd
Ridgeland, MS 39157-2206

Phone

(769) 231-9414

NPI assigned

Mar 16, 2022

Last updated

Nov 19, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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, 2018

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

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, 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 NPD

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

{
    "created_epoch": "1647388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1366190423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3912 GREAVES ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392065711",
            "telephone_number": "636-544-4472"
        },
        {
            "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": "769-231-9414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "241 Sunnybrook Rd",
            "address_purpose": "LOCATION",
            "city": "Ridgeland",
            "state": "MS",
            "postal_code": "391572206",
            "country_code": "US",
            "telephone_number": "769-231-9414",
            "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": "769-231-9414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SALEM",
        "first_name": "TABAN",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-16",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MS",
            "license": "611103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Rupp, PT, DPT
• Robert L Russell, MD
• Brandy Gail Rutherford
• Julie Michelle Sachman, SLP
• Katie Sahler, LPC
• Carrington Albernise Sallie, NP
• Larry Keith Salter Jr., OT
• Angela Marie Sanders, LCSW, LICSW
• Kishina Shontrell Sanders, FNP-C
• Michael L Sanders, MD

• 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 Nov 19, 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.