Michelle M. Kilcoyne, PH.D., LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

7430 Issued in OH

Legal business name

MICHELLE M. KILCOYNE, PH.D., LLC

Practice address

2812 Mack Rd
Fairfield, OH 45014-5130

Phone

(513) 289-1092

NPI assigned

May 25, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Michelle M. Kilcoyne, PH.D.NPI 1295273340

Title

Clinical Psychologist

Phone

(513) 289-1092

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michelle M. Kilcoyne, PH.D.

  • Clinical Psychologist
  • Fairfield, OH
  • NPI 1295273340
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1495670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1669900312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2812 MACK RD",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145130",
            "telephone_number": "513-289-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2812 MACK RD",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145130",
            "telephone_number": "513-289-1092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHELLE M. KILCOYNE, PH.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-25",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "KILCOYNE",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "513-289-1092",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "7430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Fairfield, OH
• Providers in Fairfield, OH by specialty
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.