Active NPI
Kelli Danielle Tahaney, PHD
- Psychologist
- Aurora, CO
National Provider Identifier
1083325849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY.0006005
- Practice address
- 1700 Wheeling St
Aurora, CO 80045-7211 - Phone
- (727) 479-8598
- NPI assigned
- Dec 12, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY.0006005 | CO | Primary |
Addresses
Primary practice location
1700 Wheeling St
Aurora, CO 80045-7211
Mailing address
1315 Rosewood Ave Unit 204
Boulder, CO 80304-1098
Phone (727) 479-8598
Other practice location 1
1315 Rosewood Ave Unit 204
Boulder, CO 80304-1098
Phone (727) 479-8598
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY.0006005 | CO | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1670803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670803200000",
"number": "1083325849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1315 ROSEWOOD AVE UNIT 204",
"city": "BOULDER",
"state": "CO",
"postal_code": "803041098",
"telephone_number": "727-479-8598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 WHEELING ST",
"city": "AURORA",
"state": "CO",
"postal_code": "800457211",
"telephone_number": "727-479-8598"
}
],
"practiceLocations": [
{
"address_1": "1315 Rosewood Ave Unit 204",
"address_purpose": "LOCATION",
"city": "Boulder",
"state": "CO",
"postal_code": "803041098",
"country_code": "US",
"telephone_number": "727-479-8598",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TAHANEY",
"first_name": "KELLI",
"middle_name": "DANIELLE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-12",
"last_updated": "2022-12-12",
"certification_date": "2022-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CO",
"license": "PSY.0006005",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aurora, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.