Active NPI
Kylie Pellerin, MS, LPES, NCSP
- School Psychologist
- Anderson, SC
National Provider Identifier
1043636962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 4627
- Practice address
- 315 Pearman Dairy Rd
Anderson, SC 29625-3801 - Phone
- (864) 260-5135
- NPI assigned
- Mar 17, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 4627 | SC | Primary |
Addresses
Primary practice location
315 Pearman Dairy Rd
Anderson, SC 29625-3801
Mailing address
315 Pearman Dairy Rd
Anderson, SC 29625-3801
Phone (864) 260-5135
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4627 | SC | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422403200000",
"number": "1043636962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "315 PEARMAN DAIRY RD",
"city": "ANDERSON",
"state": "SC",
"postal_code": "296253801",
"telephone_number": "864-260-5135"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 PEARMAN DAIRY RD",
"city": "ANDERSON",
"state": "SC",
"postal_code": "296253801",
"telephone_number": "864-260-5135"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PELLERIN",
"first_name": "KYLIE",
"name_prefix": "Mrs.",
"credential": "MS, LPES, NCSP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-03-17",
"last_updated": "2015-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "SC",
"license": "4627",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anderson, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.