Kelly Allison Wilcynski, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY 60231527 Issued in WA

Practice address

1800 112TH Ave NE
Suite 150
Bellevue, WA 98004-2993

Phone

(425) 646-7279

Fax

(425) 646-7499

NPI assigned

Oct 22, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Associated Behavioral Health Care Inc

  • Addiction (Substance Use Disorder) Counselor
  • Kent, WA
  • NPI 1790007896
  NPD (past)

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

{
    "created_epoch": "1224633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319155200000",
    "number": "1114179082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 112TH AVE NE",
            "address_2": "SUITE 150",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980042993",
            "telephone_number": "425-646-7279",
            "fax_number": "425-646-7499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 112TH AVE NE",
            "address_2": "SUITE 150",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980042993",
            "telephone_number": "425-646-7279",
            "fax_number": "425-646-7499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCYNSKI",
        "first_name": "KELLY",
        "middle_name": "ALLISON",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-22",
        "last_updated": "2011-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY 60231527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Hutchison Wilbour, R.PH.
• Aubrey Wilbur
• Brynn Marguerite Wilbur
• Shoshanna Beth Wilbur, MA, CCC-SLP
• John William Wilcox, D.C.
• Laura Katherine Wilder
• Melvin Louis Wilenzick, D.D.S.
• Hannah Grace Wiles
• Vanessa Wilken, MS, CF-SLP
• Shernell Lynn Wilkens, A.A.S

• Clinical Psychologist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2011; 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.