Kelly Rotella Walters, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

35SI00528600 Issued in NJ

Practice address

5 Walter E Foran Blvd Ste 2002
Flemington, NJ 08822-4674

Phone

(908) 872-3342

NPI assigned

Nov 9, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1289260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573516800000",
    "number": "1033410956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 WALTER E FORAN BLVD STE 2002",
            "city": "FLEMINGTON",
            "state": "NJ",
            "postal_code": "088224674",
            "telephone_number": "908-872-3342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 WALTER E FORAN BLVD STE 2002",
            "city": "FLEMINGTON",
            "state": "NJ",
            "postal_code": "088224674",
            "telephone_number": "908-872-3342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "KELLY",
        "middle_name": "ROTELLA",
        "name_prefix": "Ms.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-09",
        "last_updated": "2019-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00528600",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Kathryn A. Wall, APN
• Shannon Wall, COTA/L
• John M. Walsh, DVM
• Maureen K Walsh, APN BC
• Leonard R Wan, DMD
• Edward Wang, M.D.
• Jennifer J Wang, PHARMD
• Kevin Y Wang
• Carmen Cassandra Ward, LPC, ACS, NCC,CCSOTS

• Clinical Psychologist in Flemington, NJ
• Providers in Flemington, NJ by specialty
• Clinical Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.