Kelcey Lynn Puszkiewicz, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

202124 Issued in AR

Practice address

305 S Palm St
Little Rock, AR 72205-5432

Phone

(501) 686-9000

Fax

(501) 683-3677

NPI assigned

Jun 8, 2017

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

Other names 1

• Kelcey Lynn Hall Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1114456613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 S PALM ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055432",
            "telephone_number": "501-686-9000",
            "fax_number": "501-683-3677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 S PALM ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055432",
            "telephone_number": "501-686-9000",
            "fax_number": "501-683-3677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "815 W 5th North St",
            "address_purpose": "LOCATION",
            "city": "Morristown",
            "state": "TN",
            "postal_code": "378143810",
            "country_code": "US",
            "telephone_number": "423-586-5032",
            "fax_number": "423-581-8473",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUSZKIEWICZ",
        "first_name": "KELCEY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-08",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AR",
            "license": "202124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELCEY",
            "last_name": "HALL",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joshua Pursifull, M.S. L.P.C.
• Ashton Skyler Purtle-Smith, MD
• Rangarajan Purushothaman
• Jennifer M Purvis Andrews, M.D.
• Renita Sharaniya Pushparajah Mak, M.D.
• Pwclr, P.a.
• Brooklyn Pyburn, MS,RD,LD
• Rebecca Pyburn
• Sherry Elaine Pye, MNSC, APN
• Derek Bernard Pyland, MD

• Clinical Psychologist in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Clinical Psychologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.