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THERESA KELLAM PH.D. NPI 1205248150


NPI Information

NPI: 1205248150
Provider Name: THERESA KELLAM, PH.D.
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
2201 DOTTIE LYNN PKWY
SUITE 127
FORT WORTH, TX
ZIP 76120
Phone: (817) 313-7899
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THERESA KELLAM, PH.D. is a community behavioral health in Fort Worth, TX. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. THERESA KELLAM, PH.D. NPI is 1205248150. The provider is registered as an organization entity type.

The provider's business location address is:

2201 DOTTIE LYNN PKWY
SUITE 127
FORT WORTH, TX
ZIP 76120-432
Phone: (817) 313-7899

The provider's authorized official is Theresa Kellam .
The authorized official title is Owner/psychologist and has the following contact phone number (817) 313-7899.

The enumeration date for this NPI number is 5/27/2014 and was last updated on 5/27/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251S00000XCommunity/Behavioral Health32518TEXASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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