DR. DOMINIK LIA KELLER PHD
NPI 1710627922
Psychologist - School in Southaven, MS

Active since March 29, 2022
5915 GETWELL RD BLDG B, SOUTHAVEN, MS 38672(662) 349-2979 Get Directions Write a Review

NPPES record last updated: December 15, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 15, 2022, Nov 7, 2022 (2 updates tracked since 2022).

About Dr. Dominik Lia Keller Phd NPPES

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

DR. DOMINIK LIA KELLER PHD (NPI 1710627922) is an individual school provider in Southaven, Mississippi, licensed in Mississippi (621149) and active in the NPI registry since March 2022. She maintains a secondary practice location in Randolph.

NPPES Registry Identity

NPI1710627922
Entity TypeIndividualFemale
Primary Taxonomy103TS0200X
Provider Legal NameDR. DOMINIK LIA KELLERCredential: PHD
Location Address5915 GETWELL RD BLDG BSouthaven, MS 38672-6455
Mailing Address5915 Getwell Rd Bldg BSouthaven, MS 38672-6455 · (662) 349-2979
Sole ProprietorNo
Enumeration DateMarch 29, 2022
Last NPPES UpdateDecember 15, 20222 updates tracked since enumeration
NPPES CertifiedDecember 15, 2022
NPI 1710627922 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychologist · SchoolBehavioral Health & Social Service Providers
Taxonomy Code103TS0200X
License Licensed in MS · 621149
Definition
A psychologist whose specialty is concerned with the science and practice of psychology with children, youth, families; learners of all ages; and the schooling process. The basic education and training of school psychologists prepares them to provide a range of psychological diagnosis, assessment, intervention, prevention, health promotion, and program development and evaluation services with a special focus on the developmental processes of children and youth within the context of schools, families and other systems. School psychologists are prepared to intervene at the individual and system level, and develop, implement, and evaluate preventive programs. In these efforts, they conduct ecologically valid assessments and intervene to promote positive learning environments within which children and youth from diverse backgrounds to ensure that all have equal access to effective educational and psychological services that promote healthy development
Also ListedBehavior TechnicianTaxonomy 106S00000X
5915 GETWELL RD BLDG B, Southaven, MS 38672

Secondary Practice Location 1

Location 141 Pacella Park DrRandolph, MA 02368-1755 · Phone (781) 437-1381

Other Identifiers 2

Medicaid200000200MS
Medicaid110026265EMA

Accepted Insurance

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.

Social Worker (Clinical)
5915 GETWELL RD BLDG B
SOUTHAVEN, MS 38672
Nurse Practitioner (Psychiatric/Mental Health)
5915 GETWELL RD BLDG B
SOUTHAVEN, MS 38672
Counselor
5915 GETWELL RD BLDG B
SOUTHAVEN, MS 38672
Counselor
5915 GETWELL RD BLDG B
SOUTHAVEN, MS 38672
Nurse Practitioner (Psychiatric/Mental Health)
5915 GETWELL RD BLDG B
SOUTHAVEN, MS 38672
Counselor (Professional)
5915 GETWELL RD BLDG B
SOUTHAVEN, MS 38672
Social Worker (Clinical)
5915 GETWELL RD BLDG B
SOUTHAVEN, MS 38672
Counselor (Mental Health)
5915 GETWELL RD BLDG B
SOUTHAVEN, MS 38672

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 Dominik Keller's NPI number?

The NPI number for Dominik Keller is 1710627922. It was assigned to this individual provider in the NPPES registry on March 29, 2022.

Where is Dominik Keller located?

Dominik Keller practices at 5915 Getwell Rd Bldg B, Southaven, MS 38672. The listed phone number is (662) 349-2979.

What is Dominik Keller's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in School, with taxonomy code 103TS0200X.

What insurance does Dominik Keller accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of Tennessee and 4 other insurers list Dominik Keller as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Dominik Keller was last updated on December 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.