Katherine Mary Kalliel, ED.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

5091 Issued in MA

Practice address

72 Fulton St
Norwood, MA 02062

Phone

(781) 769-4233

NPI assigned

Jul 14, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1124044375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 FULTON ST",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020622320",
            "telephone_number": "781-769-4233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 FULTON ST",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "02062",
            "telephone_number": "781-769-4233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Kindred Hospital Northeast Stoughton",
            "address_2": "909 Sumner Street",
            "address_purpose": "LOCATION",
            "city": "Stoughton",
            "state": "MA",
            "postal_code": "02072",
            "country_code": "US",
            "telephone_number": "781-297-8349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KALLIEL",
        "first_name": "KATHERINE",
        "middle_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "5091",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "MA",
            "license": "5091",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MA",
            "license": "5091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Neuropsychologist in Norwood, MA
• Providers in Norwood, MA by specialty
• Clinical Neuropsychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; 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.