Kelly Petrino, PSYD

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

505 Issued in WY

Legal business name

KELLY PETRINO, PSYD

Practice address

507 S 4TH St
Laramie, WY 82070-3753

Phone

(307) 460-0781

Fax

(307) 742-4089

NPI assigned

Apr 7, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Kelly Petrino, PSYD

Title

Psychologist/Owner

Phone

(307) 460-0781

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1428364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428364800000",
    "number": "1548656523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 S 4TH ST",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820703753",
            "telephone_number": "307-460-0781",
            "fax_number": "307-742-4089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 S 4TH ST",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820703753",
            "telephone_number": "307-460-0781",
            "fax_number": "307-742-4089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY PETRINO, PSYD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-07",
        "last_updated": "2015-04-07",
        "status": "A",
        "authorized_official_last_name": "PETRINO",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "307-460-0781",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": "WY",
            "license": "505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "151943",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katie Keller, LPC
• Michelle Keller
• Stephanie Mae Keller
• Marcia Bell Kelley, M.S., CCC-SLP
• Benjamin Frank Kellner, A.T.C, L.A.T.
• Catherine Kelly, LPC
• Kaycee Kelly
• Tigerlily Kelly
• Diane A Kempson, MSW, PHD
• Sophia Kenney-Tolentino, PCSW

• Counseling Psychologist in Laramie, WY
• Providers in Laramie, WY by specialty
• Counseling Psychologist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2015; 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.