Kaylene Irizarry, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

P.08428 Issued in OH

Practice address

819 Southwestern Run # 2
Poland, OH 44514-3688

Phone

(330) 953-1354

Fax

(330) 953-1364

NPI assigned

Oct 15, 2018

Last updated

Jan 15, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Clinical Psychologist

Education

Philadelphia College of Osteopathic Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Counseling Solutions LLCGroup PAC ID 2860799459, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Advanced Counseling Solutions LLC

  • Counselor
  • Austintown, OH
  • NPI 1699098418
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673740800000",
    "number": "1487120770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5545",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445140545",
            "telephone_number": "330-953-1354",
            "fax_number": "330-953-1364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 SOUTHWESTERN RUN # 2",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445143688",
            "telephone_number": "330-953-1354",
            "fax_number": "330-953-1364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRIZARRY",
        "first_name": "KAYLENE",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-15",
        "last_updated": "2023-01-15",
        "certification_date": "2023-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": "37AC00371900",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.2103689",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "P.08428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Humphries, NCC, LSW, LPCC
• Robert E Hunt, MD
• Brian A Hutchinson
• Annette Brucoli Hutchison, LISW-S
• Inspire Behavioral Health
• Liz Irizarry
• Joseph Ivey
• James N Pantelakis MD Inc
• James N. Kozlow D.D.S. Inc.
• Cynthia Johnson, RPH

• Psychologist in Poland, OH
• Providers in Poland, OH by specialty
• Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2023; 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.

Verify at the official NPI Registry.