Active NPI
Kelly Marie Whaling, PHD
- Clinical Psychologist
- Taylorsville, UT
National Provider Identifier
1174044051
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 12466836-2501
- Practice address
- 5770 S 1500 W BLDG G
Taylorsville, UT 84123-5216 - Phone
- (801) 313-7770
- NPI assigned
- Jun 30, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Clinical Psychologist | 103TC0700X | 12466836-2504 | UT | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Psychologist | 103TC0700X | 12466836-2501 | UT | Primary |
Addresses
Primary practice location
5770 S 1500 W BLDG G
Taylorsville, UT 84123-5216
Mailing address
5770 S 1500 W BLDG G
Taylorsville, UT 84123-5216
Phone (801) 313-7770
Other practice location 1
1236 Chapala St
Santa Barbara, CA 93101
Phone (805) 965-2376
Other practice location 2
1339 20th St
Santa Monica, CA 90404-2033
Phone (310) 829-8455
Other practice location 3
4333 E Vineyard Ave
Oxnard, CA 93036-1013
Phone (805) 981-5581
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12466836-2504 | UT | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658880000000",
"number": "1174044051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5770 S 1500 W BLDG G",
"city": "TAYLORSVILLE",
"state": "UT",
"postal_code": "841235216",
"telephone_number": "801-313-7770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5770 S 1500 W BLDG G",
"city": "TAYLORSVILLE",
"state": "UT",
"postal_code": "841235216",
"telephone_number": "801-313-7770"
}
],
"practiceLocations": [
{
"address_1": "1236 Chapala St",
"address_purpose": "LOCATION",
"city": "Santa Barbara",
"state": "CA",
"postal_code": "93101",
"country_code": "US",
"telephone_number": "805-965-2376",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1339 20th St",
"address_purpose": "LOCATION",
"city": "Santa Monica",
"state": "CA",
"postal_code": "904042033",
"country_code": "US",
"telephone_number": "310-829-8455",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4333 E Vineyard Ave",
"address_purpose": "LOCATION",
"city": "Oxnard",
"state": "CA",
"postal_code": "930361013",
"country_code": "US",
"telephone_number": "805-981-5581",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WHALING",
"first_name": "KELLY",
"middle_name": "MARIE",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-30",
"last_updated": "2022-07-27",
"certification_date": "2022-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "UT",
"license": "12466836-2504",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "UT",
"license": "12466836-2501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Taylorsville, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.