DR. KELLY NICOLE BANNEYER PHD
NPI 1104314533
Psychologist - Clinical Child & Adolescent in Houston, TX

Q: What is Kelly Banneyer's NPI number?

The NPI number for Kelly Banneyer is 1104314533. It was assigned to this individual provider in the NPPES registry on May 1, 2018.

Q: What is Kelly Banneyer's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical Child & Adolescent, with taxonomy code 103TC2200X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Banneyer was last updated on May 1, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.

Active since May 01, 2018PECOS Enrolled

6701 FANNIN ST STE 1630, HOUSTON, TX 77030(832) 822-3700(832) 825-4164 Get Directions Write a Review

NPPES record last updated: May 1, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Kelly Nicole Banneyer Phd NPPES

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

DR. KELLY NICOLE BANNEYER PHD (NPI 1104314533) is an individual clinical child & adolescent provider in Houston, Texas, licensed in Texas (37690) and active in the NPI registry since May 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104314533

Entity TypeIndividualFemale

Primary Taxonomy103TC2200X

Provider Legal NameDR. KELLY NICOLE BANNEYERCredential: PHD

Location Address6701 FANNIN ST STE 1630Houston, TX 77030-2615

Mailing Address6701 Fannin St Ste 1630Houston, TX 77030-2615 · (832) 822-3700 · Fax (832) 825-4164

Phone(832) 822-3700

Fax(832) 825-4164

Sole ProprietorNo

Enumeration DateMay 1, 2018

✔ NPI 1104314533 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · Clinical Child & AdolescentBehavioral Health & Social Service Providers

Taxonomy Code103TC2200X

License✔ Licensed in TX · 37690

Definition

A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents.

6701 FANNIN ST STE 1630, Houston, TX 77030

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kelly Nicole Banneyer Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNIFER AGNES REECE BCBA

Behavior Analyst