Kerry Ann Kennelly, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS016023 Issued in PA

Practice address

2676 California Ave
Pittsburgh, PA 15212-2669

Phone

(412) 716-2078

Fax

(412) 766-1731

NPI assigned

Jul 20, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Senior Life Washington

  • Nursing Facility/Intermediate Care Facility
  • Washington, PA
  • NPI 1093109860
  NPD (past)
• Seniorlife Washington, Inc.

  dba SeniorLife Washington

  • PACE Provider Organization
  • Washington, PA
  • NPI 1497998876
  NPD (past)

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219795200000",
    "number": "1538189774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2676 CALIFORNIA AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152122669",
            "telephone_number": "412-716-2078",
            "fax_number": "412-766-1731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2676 CALIFORNIA AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152122669",
            "telephone_number": "412-716-2078",
            "fax_number": "412-766-1731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNELLY",
        "first_name": "KERRY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2008-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS016023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1015604510001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD",
            "identifier": "P00290787",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patrick James Kennedy, M.D.
• Reiley Kennedy
• Rory Kennedy, CCC-SLP
• Traci Michelle Kennedy, PHD
• Gabrielle Elizabeth Kennelley, MD
• Shawn Kennemuth, DO
• Christina B Kenney
• Jennifer Lynn Kenney, MSW, LSW, MPH
• Justin Kenney, MD
• Makenzie Kincaid Kenney, LSW, MPH

• Clinical Psychologist in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.