Celeste Macdonald Kelly, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810007032 Issued in VA

Practice address

250 Wylderose CMNS
Midlothian, VA 23113-6883

Phone

(804) 214-6198

NPI assigned

Aug 1, 2020

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Rewild, PLLC

  • Adult Mental Health Clinic/Center
  • Richmond, VA
  • NPI 1912730458
  NPD Authorized official

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

{
    "created_epoch": "1596240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1699385013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 BROWNS HILL CT",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231149511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 WYLDEROSE CMNS",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231136883",
            "telephone_number": "804-214-6198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "CELESTE",
        "middle_name": "MACDONALD",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-01",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810007032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Achille Keller, MD
• Gordon Neil Kellett II, M.D.
• Alesha Nicol Kelley, COTA/L
• Ashley Redden Kelley, DPT
• Jason Kelley, PT, DPT
• James A Kelly, DDS
• Jeremy Scott Kennedy, D.O.
• Sara Kenney
• Glenn J. Kerr, M.D.
• Ketavia

• Clinical Psychologist in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; 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.