Siobhan Donnelly, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

019370 Issued in NY

Practice address

5116 Dorsey Hall Dr Ste B
Ellicott City, MD 21042-7877

Phone

(410) 995-8274

NPI assigned

Jul 2, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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 4, 2020 through Nov 4, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1404259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550620800000",
    "number": "1669888392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5116 DORSEY HALL DR STE B",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427877",
            "telephone_number": "917-584-5702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5116 DORSEY HALL DR STE B",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427877",
            "telephone_number": "410-995-8274"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "519 8th Ave Rm 9",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100184582",
            "country_code": "US",
            "telephone_number": "212-683-3339 x149",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "276 5th Ave",
            "address_2": "Suite 1101",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100014509",
            "country_code": "US",
            "telephone_number": "212-683-3339 x149",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1407 Eutaw Pl Apt 4",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212174048",
            "country_code": "US",
            "telephone_number": "917-584-5702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "SIOBHAN",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-02",
        "last_updated": "2019-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "019370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Duffy Doherty Jr., ED.S.
• Kathleen Dolan, LCPC
• Don a. Coronel, DDS, PA
• Dolores Ann Donnelly, CRNA
• Elizabeth Donnelly
• Jennifer Dorsey, LPC, LCPC, CAC-I
• Lynne Denise Dorsey, MS, OT/L
• James Craig Doty, PHARMD
• Biliki S Douglas, PMHNP-BC
• Laurie Marie Downin

• Clinical Psychologist in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Clinical Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.