KILLEBREW PSYCHOLOGICAL SERVICES, LLC
NPI 1073988051
Psychologist in Madison, MS

Active since December 02, 2015
133 BERRY LN, MADISON, MS 39110(601) 750-6102 Get Directions Write a Review

NPPES record last updated: February 3, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 19, 2024, Feb 3, 2022, Dec 2, 2015 (3 updates tracked since 2015).

About Killebrew Psychological Services, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KILLEBREW PSYCHOLOGICAL SERVICES, LLC (NPI 1073988051) is a healthcare organization registered as a psychologist in Madison, Mississippi and active in the NPI registry since December 2015. The organization maintains a secondary practice location in Ridgeland and lists Alyssa E. Killebrew, Clinical Psychologist, as its authorized official.

NPPES Registry Identity

NPI1073988051
Entity TypeOrganization
Primary Taxonomy103T00000X
Legal Business NameKILLEBREW PSYCHOLOGICAL SERVICES, LLC
Location Address133 BERRY LNMadison, MS 39110-8616
Mailing Address133 Berry LnMadison, MS 39110-8616 · (601) 750-6102
Organization SubpartNo
Authorized OfficialAlyssa E. KillebrewClinical Psychologist · (601) 750-6102
Enumeration DateDecember 2, 2015
Last NPPES UpdateFebruary 3, 20223 updates tracked since enumeration
NPPES CertifiedFebruary 3, 2022
✔ NPI 1073988051 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in MS · 54946
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X · License 54946 (MS)
Also ListedHealth Maintenance OrganizationTaxonomy 302R00000X · License 54946 (MS)
133 BERRY LN, Madison, MS 39110

Secondary Practice Location 1

Location 1210 W Jackson StRidgeland, MS 39157-2312 · Phone (769) 231-9414

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Killebrew Psychological Services, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

17

Medicare enrollment records show 17 clinicians reassign Medicare billing to Killebrew Psychological Services, LLC, which bills Medicare for the services they deliver. Of these, 11 practice within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 3

Mental Health Counselor11
Clinical Psychologist3
Clinical Social Worker3

Clinicians, nearest first (17)

Mental Health Counselor
NPI 1336656131
241 SUNNYBROOK RD
Ridgeland, MS 39157
(769) 231-9414
✔ PECOS✔ Accepts Medicare1.9 mi
Mental Health Counselor
NPI 1245837756
241 SUNNYBROOK RD
Ridgeland, MS 39157
(769) 231-9414
✔ PECOS✔ Accepts Medicare1.9 mi
Clinical Psychologist
NPI 1306130125
241 SUNNYBROOK RD
Ridgeland, MS 39157
(601) 624-5912
✔ PECOS✔ Accepts Medicare1.9 mi
Clinical Psychologist
NPI 1366190423
241 SUNNYBROOK RD
Ridgeland, MS 39157
(769) 231-9414
✔ PECOS✔ Accepts Medicare1.9 mi
Mental Health Counselor
NPI 1962399840
241 SUNNYBROOK RD
Ridgeland, MS 39157
(769) 231-9414
✔ PECOS✔ Accepts Medicare1.9 mi
Mental Health Counselor
NPI 1467035873
105 W WASHINGTON ST
Ridgeland, MS 39157
(601) 790-7019
✔ PECOS✔ Accepts Medicare2.3 mi
Mental Health Counselor
NPI 1609558261
210 W JACKSON ST
Ridgeland, MS 39157
(769) 231-9414
✔ PECOS✔ Accepts Medicare2.3 mi
Mental Health Counselor
NPI 1366186785
210 W JACKSON ST
Ridgeland, MS 39157
(601) 525-6093
✔ PECOS✔ Accepts Medicare2.6 mi
Clinical Social Worker
NPI 1164020848
601 RENAISSANCE WAY
Ridgeland, MS 39157
(601) 586-1016
✔ PECOS✔ Accepts Medicare3.1 mi
Clinical Psychologist
NPI 1871818369
357 TOWNE CENTER BLVD STE 403
Ridgeland, MS 39157
(601) 869-5898
✔ PECOS✔ Accepts Medicare3.9 mi
Clinical Social Worker
NPI 1356123921
135 BOUNDS ST
Jackson, MS 39206
(601) 918-2079
✔ PECOS✔ Accepts Medicare6.2 mi
Mental Health Counselor
NPI 1245873595
1151 N STATE ST STE 212
Jackson, MS 39202
(601) 352-7398
✔ PECOS✔ Accepts Medicare10 mi
Mental Health Counselor
NPI 1316293095
200 N CONGRESS ST SUITE 100
Jackson, MS 39201
(601) 376-3787
✔ PECOS✔ Accepts Medicare11 mi
Mental Health Counselor
NPI 1346080116
604 HIGHWAY 80 W STE R
Clinton, MS 39056
(601) 519-1770
✔ PECOS✔ Accepts Medicare13 mi
Mental Health Counselor
NPI 1538871272
613 MARQUETTE RD
Brandon, MS 39042
(601) 824-1692
✔ PECOS✔ Accepts Medicare15 mi
Mental Health Counselor
NPI 1982838314
9 COUNTY ROAD 153
Laurel, MS 39443
(601) 670-1377
✔ PECOS✔ Accepts Medicare81 mi
Clinical Social Worker
NPI 1760258917
501 PARK LN
Oxford, MS 38655
(601) 573-4770
✔ PECOS✔ Accepts Medicare135 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Killebrew Psychological Services, LLC's NPI number?

The NPI number for Killebrew Psychological Services, LLC is 1073988051. It was assigned to this organization in the NPPES registry on December 2, 2015.

Where is Killebrew Psychological Services, LLC located?

Killebrew Psychological Services, LLC is located at 133 Berry Ln, Madison, MS 39110. The listed phone number is (601) 750-6102.

What is Killebrew Psychological Services, LLC's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Killebrew Psychological Services, LLC enrolled in Medicare?

Yes. Killebrew Psychological Services, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Killebrew Psychological Services, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 17 clinicians in 3 Medicare specialties reassign their Medicare billing to Killebrew Psychological Services, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Mental Health Counselor (11), Clinical Psychologist (3) and Clinical Social Worker (3). Of these, 11 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Killebrew Psychological Services, LLC was last updated on February 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.