Individual provider Active NPI

Joan M. Kellerman, PH.D.

  • Cognitive & Behavioral Psychologist
  • Sharon, MA
National Provider Identifier
1255410411
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
License
2963 Issued in MA
Practice address
80 Upland Rd
Sharon, MA 02067-1748
Phone
(781) 784-8372
NPI assigned
Nov 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X 2963 MA Primary
Clinical Psychologist 103TC0700X 2963 MA

Addresses

Primary practice location

80 Upland Rd
Sharon, MA 02067-1748

Mailing address

80 Upland Rd
Sharon, MA 02067-1748
Phone (781) 784-8372

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20120511000200 MA Practitioner - Clinical Psychologist 1254594153 Practice locations: Sharon, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

80 Upland Rd
Sharon, MA 02067-1748
Phone (781) 784-8372

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2963MAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1255410411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 UPLAND RD",
            "city": "SHARON",
            "state": "MA",
            "postal_code": "020671748",
            "telephone_number": "781-784-8372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 UPLAND RD",
            "city": "SHARON",
            "state": "MA",
            "postal_code": "020671748",
            "telephone_number": "781-784-8372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLERMAN",
        "first_name": "JOAN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MA",
            "license": "2963",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "2963",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sharon, MA

Sources for this page

Verify at the official NPI Registry.