Kelly Coulehan Crotty, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

022496-1 Issued in NY

Practice address

4 Smith Haven Mall Ste 107
Lake Grove, NY 11755-1219

Phone

(646) 580-5107

NPI assigned

Jun 11, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Credentials

Doctor of Philosophy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kelly.coulehancrotty@direct.stonybrookmedicine.edu

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.

• University Hospital at Stony Brook

  • General Acute Care Hospital
  • Stony Brook, NY
  • NPI 1972523348
  NPD

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

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766016000000",
    "number": "1548829880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 SMITH HAVEN MALL STE 107",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117551219",
            "telephone_number": "646-580-5107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 SMITH HAVEN MALL STE 107",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117551219",
            "telephone_number": "646-580-5107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COULEHAN CROTTY",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-11",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "022496-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "kelly.coulehan@stonybrookmedicine.edu",
            "affiliation": "Y",
            "endpointDescription": "email",
            "affiliationName": "Stony Brook University Medical Center",
            "address_1": "14 Technology Dr Ste 12B",
            "city": "East Setauket",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117333469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Melissa Ann Crimi, PNP
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• Kristen D'Aquila

• Clinical Psychologist in Lake Grove, NY
• Providers in Lake Grove, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2025; 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.