Individual provider Active NPI

Kelly E Naylor, PH.D.

  • Clinical Psychologist
  • Wheat Ridge, CO
National Provider Identifier
1699057372
Registry record updated Sep 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2063 Issued in CO
Practice address
4851 Independence St
Suite 200
Wheat Ridge, CO 80033-6715
Phone
(303) 489-1886
NPI assigned
Sep 19, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2063 CO Primary

Addresses

Primary practice location

4851 Independence St
Suite 200
Wheat Ridge, CO 80033-6715

Mailing address

1156 Preserve Cir
Golden, CO 80401-7045
Phone (303) 489-1886

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
2063COMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1316390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316390400000",
    "number": "1699057372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1156 PRESERVE CIR",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804017045",
            "telephone_number": "303-489-1886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4851 INDEPENDENCE ST",
            "address_2": "SUITE 200",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336715",
            "telephone_number": "303-489-1886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAYLOR",
        "first_name": "KELLY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-19",
        "last_updated": "2011-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "2063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheat Ridge, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2011; 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.