Kelly M Carpenter, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY00002546 Issued in WA

Practice address

10740 Meridian Ave N
Suite 110
Seattle, WA 98133-9010

Phone

(206) 696-2792

NPI assigned

Sep 4, 2008

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

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1220486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220486400000",
    "number": "1144478918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10740 MERIDIAN AVE N",
            "address_2": "SUITE 110",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981339010",
            "telephone_number": "206-696-2792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10740 MERIDIAN AVE N",
            "address_2": "SUITE 110",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981339010",
            "telephone_number": "206-696-2792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "KELLY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-04",
        "last_updated": "2008-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "WA",
            "license": "PY00002546",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00002546",
            "primary": true
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "WA",
            "license": "PY00002546",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Or'Deal Carpenter, CDPT
• Brianna Carpenter
• Catherine Suzanne Carpenter, LMP
• Grace Stephanie Jeanne Carpenter, LMHC
• Heather J Carpenter, L.L.
• Lauren Elizabeth Carpenter, MD
• Leslie A. Carpenter, MGC
• Nicholas Eugene Carpenter, PA-C
• Paul Andrew Carpenter
• Robert L. Carpenter, PH.D

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2008; 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.