NPIMap

Organization Active NPI

Kelly Copeland PSYD LLC

  • Clinical Psychologist
  • Stamford, CT
National Provider Identifier
1336788488
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
KELLY COPELAND PSYD LLC
Practice address
1200 High Ridge Rd Ste 208
Stamford, CT 06905-1202
Phone
(203) 539-1033
NPI assigned
Jan 6, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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

Authorized official

Name
Kelly Copeland, PSYDNPI 1144869884
Title
Psychologist
Phone
(585) 245-3900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

1200 High Ridge Rd Ste 208
Stamford, CT 06905-1202

Mailing address

36 Ridge Brook LN
Stamford, CT 06903-1239
Phone (585) 245-3900

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1578268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578268800000",
    "number": "1336788488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 RIDGE BROOK LN",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069031239",
            "telephone_number": "585-245-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 HIGH RIDGE RD STE 208",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069051202",
            "telephone_number": "203-539-1033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY COPELAND PSYD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-06",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A",
        "authorized_official_last_name": "COPELAND",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "585-245-3900",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2020; 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.