Active NPI
Kelly Breen Boyce, PSY.D.,
- Clinical Psychologist
- Charlotte, NC
National Provider Identifier
1629276340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3780
- Practice address
- 1116 Greenwood CLFS
Charlotte, NC 28204-2821 - Phone
- (704) 334-0524
- Fax
- (704) 334-0524
- NPI assigned
- Jul 3, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6556 | NC | |
| Marriage & Family Therapist | 106H00000X | 1353 | NC | |
| Clinical Psychologist | 103TC0700X | 3780 | NC | Primary |
Addresses
Primary practice location
1116 Greenwood CLFS
Charlotte, NC 28204-2821
Mailing address
1116 Greenwood CLFS
Charlotte, NC 28204-2821
Phone (704) 334-0524
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 19, 2024 through Jan 19, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3780 | NC | MD | Professional Counselor |
| 6556 | NC | MD | Pharmacist |
| 1353 | NC | MD | Audiologist-Hearing Aid Fitter |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bareiter Counseling Center | Professional | Past | 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 and National Provider Directory roles.
-
- Professional Counselor
- Charlotte, NC
- NPI 1548455876
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346025600000",
"number": "1629276340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1116 GREENWOOD CLFS",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282042821",
"telephone_number": "704-334-0524",
"fax_number": "704-334-0524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1116 GREENWOOD CLFS",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282042821",
"telephone_number": "704-334-0524",
"fax_number": "704-334-0524"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYCE",
"first_name": "KELLY",
"middle_name": "BREEN",
"name_prefix": "Dr.",
"credential": "PSY.D.,",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-03",
"last_updated": "2012-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "6556",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NC",
"license": "1353",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "3780",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.