Individual provider Active NPI

Jessalyn Rose Kelleher, PSYD

  • Clinical Psychologist
  • Aurora, CO
National Provider Identifier
1235619842
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY.0005145 Issued in CO
Practice address
1890 N Revere CT
Aurora, CO 80045-7464
Phone
(303) 724-1646
NPI assigned
Aug 14, 2018
Last updated
May 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Psychologist 103TC0700X PSY.0005145 CO Primary

Addresses

Primary practice location

1890 N Revere CT
Aurora, CO 80045-7464

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Other practice location 1

13001 E 17th Pl
Aurora, CO 80045-2570
Phone (303) 724-9758

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, MA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200915001397 CO Practitioner - Clinical Psychologist 6709204241 Reassigns benefits to 2 organizations
I20260327002148 MA Practitioner - Clinical Psychologist 6709204241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

PO Box
Suite 110429
Aurora, CO 80042

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY.0005145COMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians, Incorporated CurrentSince Sep 1, 2020 Accepting new patients
University Physicians Incorporated CurrentSince Sep 1, 2020 Accepting new patients
University of Colorado Hospital Authority CurrentSince Sep 1, 2020 Accepting new patients
University Physicians Incorporated Current Accepting new patients
University of Colorado Hospital Authority CurrentSince Sep 1, 2020 Accepting new patients

Locations

12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0006

13001 E 17th Pl
Aurora, CO 80045
Phone (303) 724-1792

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

13123 E 16th Ave
#B130
Aurora, CO 80045
Phone (720) 777-6200

1635 Aurora Ct
Aurora, CO 80045
Phone (720) 848-1060

1890 N Revere Ct
Aurora, CO 80045
Phone (303) 724-1000

1890 N Revere Ct
#5003
Aurora, CO 80045

1890 N Revere Ct
Ste 5003
Aurora, CO 80045
Phone (218) 275-0150

7901 E Lowry Blvd
Ste 3
Denver, CO 80230

Dept 1061
Denver, CO 80256

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2403

7403 Church Ranch Blvd
Westminster, CO 80021
Phone (720) 848-9400

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1534204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1235619842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 N REVERE CT",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457464",
            "telephone_number": "303-724-1646"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13001 E 17th Pl",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800452570",
            "country_code": "US",
            "telephone_number": "303-724-9758",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLEHER",
        "first_name": "JESSALYN",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-14",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY.0005145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.