Active NPI
Kelsi Nummerdor, PHD
- Counseling Psychologist
- Athens, GA
National Provider Identifier
1871366724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- PSY004741
- Practice address
- 240 Old Epps Bridge Rd
Athens, GA 30606-2876 - Phone
- (706) 850-7041
- NPI assigned
- Nov 2, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | PSY004741 | GA | Primary |
Addresses
Primary practice location
240 Old Epps Bridge Rd
Athens, GA 30606-2876
Mailing address
240 Old Epps Bridge Rd
Athens, GA 30606-2876
Phone (706) 850-7041
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY004741 | GA | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703203200000",
"number": "1871366724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 OLD EPPS BRIDGE RD",
"city": "ATHENS",
"state": "GA",
"postal_code": "306062876",
"telephone_number": "706-850-7041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 OLD EPPS BRIDGE RD",
"city": "ATHENS",
"state": "GA",
"postal_code": "306062876",
"telephone_number": "706-850-7041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NUMMERDOR",
"first_name": "KELSI",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-02",
"last_updated": "2023-12-22",
"certification_date": "2023-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "GA",
"license": "PSY004741",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Athens, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.