Individual provider Active NPI

Kevin Patrick Duffy, PSY.D.

  • School Psychologist
  • Tonawanda, NY
National Provider Identifier
1578616603
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
68 015908 Issued in NY
Practice address
884 Brighton Rd
Tonawanda, NY 14150-8169
Phone
(716) 836-9460
Fax
(716) 836-9462
NPI assigned
Jan 20, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 68 015908 NY
Clinical Child & Adolescent Psychologist 103TC2200X 68 015908 NY
School Psychologist 103TS0200X 68 015908 NY Primary

Addresses

Primary practice location

884 Brighton Rd
Tonawanda, NY 14150-8169

Mailing address

884 Brighton Rd
Tonawanda, NY 14150-8169
Phone (716) 836-9460

Other identifiers 4

IdentifierTypeStateIssuer
6112738OtherNYIHA
00026901802OtherNYUNIVERA
539875OtherNYVO
000527938003OtherNYBC BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
68 015908NYMDClinical Child & Adolescent Psychologist
015908NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Buffalo Psychology Group PastSince Aug 15, 2023 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1169251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1578616603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "884 BRIGHTON RD",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141508169",
            "telephone_number": "716-836-9460",
            "fax_number": "716-836-9462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "884 BRIGHTON RD",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141508169",
            "telephone_number": "716-836-9460",
            "fax_number": "716-836-9462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUFFY",
        "first_name": "KEVIN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-20",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "68 015908",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "68 015908",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "NY",
            "license": "68 015908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA",
            "identifier": "6112738",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00026901802",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VO",
            "identifier": "539875",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "000527938003",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tonawanda, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.