Kristin L Daley, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

4239 Issued in NC

Practice address

1515 Mockingbird LN Ste 580
Charlotte, NC 28209

Phone

(704) 910-8381

Fax

(704) 981-8282

NPI assigned

Mar 22, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 13, 2019 through Nov 13, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

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.

• Base, PLLC

  • Psychologist
  • Charlotte, NC
  • NPI 1265936108
  NPD (past)
• Charlotte Eye Ear Nose & Throat Associates, P.a.

  • Ophthalmology Physician
  • Charlotte, NC
  • NPI 1043287469
  NPD (past)

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

{
    "created_epoch": "1300752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567036800000",
    "number": "1558660175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 MOCKINGBIRD LN STE 580",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282091171",
            "telephone_number": "704-910-8381",
            "fax_number": "704-981-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 MOCKINGBIRD LN STE 580",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28209",
            "telephone_number": "704-910-8381",
            "fax_number": "704-981-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALEY",
        "first_name": "KRISTIN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-22",
        "last_updated": "2019-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173F00000X",
            "taxonomy_group": "",
            "desc": "Sleep Specialist, PhD",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "4239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Dale-Shall
• Mary Jane Dale
• Racquel Daley-Placide, M.D.
• Jean Michelle Daley, LCMHC
• Katherine E Daley, P.A.
• Toshana Daley
• Anu Dali, D.D.S.
• Mary Winston Dozier Dalrymple, LCMHCA
• Raj Dalsania, M.D.
• Ariyan Shyneek Dalton

• Psychologist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2019; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.