Kevin J. Kelley, PH.D.

Primary specialty

Adult Development & Aging PsychologistTaxonomy code 103TA0700X

License

PS005818L Issued in PA

Practice address

530 Union Blvd
Allentown, PA 18109-3230

Phone

(610) 435-1541

Fax

(610) 435-4367

NPI assigned

Mar 10, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Catholic Charities of the Diocese of Allentown Inc

  • Community/Behavioral Health Agency
  • Allentown, PA
  • NPI 1487866463
  NPD

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

{
    "created_epoch": "1173484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414972800000",
    "number": "1093847584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 UNION BLVD",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181093230",
            "telephone_number": "610-435-1541",
            "fax_number": "610-435-4367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 UNION BLVD",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181093230",
            "telephone_number": "610-435-1541",
            "fax_number": "610-435-4367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "KEVIN",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-10",
        "last_updated": "2014-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "PA",
            "license": "PS005818L",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "PA",
            "license": "PS005818L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "763740",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Keiderling, LSW, MSW, CPRP
• Drew Michael Keister, M.D.
• Dawn Lee Keller-Malesky, RRT
• Erika Keller, CRNP
• Erika Keller, CNM
• Shannon Kelley, PSY.D.
• Sharin P Kelley, CRNP
• Anita L Kelly, MA LPC
• Gail Kelly, R.N.
• Joseph B Kelly, LPC

• Adult Development & Aging Psychologist in Allentown, PA
• Providers in Allentown, PA by specialty
• Adult Development & Aging Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.