Active NPI
Katherine T. Kelly, PH.D.
- Clinical Psychologist
- Winston Salem, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2729
- Practice address
- 1001 Reynolda Rd
Stockton Cottage
Winston-Salem, NC 27104-3245 - Phone
- (336) 723-1011
- Fax
- (336) 723-1411
- NPI assigned
- Feb 28, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2729 | NC | Primary |
Addresses
Primary practice location
1001 Reynolda Rd
Stockton Cottage
Winston-Salem, NC 27104-3245
Mailing address
148 Carrisbrooke LN
Winston-Salem, NC 27104-2528
Phone (336) 406-8431
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
2990 Bethesda PL
Suite 602a
Winston Salem, NC 27103-3314
Phone (336) 659-3923
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2729 | NC | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Katherine T. Kelly, PH.D., LLC | Current | Accepting new patients |
Locations
3000 Bethesda Pl
Ste 201
Winston Salem, NC 27103
Phone (336) 659-3923
1001 Reynolda Rd
Winston Salem, NC 27104
Phone (336) 721-7600
2990 Bethesda Pl
Ste 602A
Winston Salem, NC 27103
Phone (336) 659-3923
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Branches Holistic Health and Wellness
- Psychologist
- Winston Salem, NC
- NPI 1902916653
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1407822372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "148 CARRISBROOKE LN",
"city": "WINSTON-SALEM",
"state": "NC",
"postal_code": "271042528",
"telephone_number": "336-406-8431",
"fax_number": "336-732-1411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 REYNOLDA RD",
"address_2": "STOCKTON COTTAGE",
"city": "WINSTON-SALEM",
"state": "NC",
"postal_code": "271043245",
"telephone_number": "336-723-1011",
"fax_number": "336-723-1411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "KATHERINE",
"middle_name": "T.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-28",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "2729",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.