DR. KELLY NICOLE BANNEYER PHD - NPI 1104314533

Q: What is the provider's specialty?

The provider's specialty is Psychologist with taxonomy code 103TC2200X and a focus in Clinical Child & Adolescent.

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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

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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.