Katharine Elizabeth Donnelly, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

020279 Issued in NY

Practice address

935 Northern Blvd
Suite #102
Great Neck, NY 11021-5316

Phone

(516) 487-7116

NPI assigned

Sep 23, 2013

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 May 20, 2019 through May 20, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Palisades Psychological Services PC

  • Clinical Psychologist
  • Nyack, NY
  • NPI 1518008036
  NPD (past)

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

{
    "created_epoch": "1379894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379894400000",
    "number": "1710313770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 NORTHERN BLVD",
            "address_2": "SUITE #102",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215316",
            "telephone_number": "516-487-7116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 NORTHERN BLVD",
            "address_2": "SUITE #102",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215316",
            "telephone_number": "516-487-7116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "KATHARINE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-23",
        "last_updated": "2013-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "020279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Don
• Hayley Donaldson, MD
• Raeann Nicole Dong
• Donna Lederman Speech-Language Pathologist, P.C.
• Donna M. Brook, Family NP, PC
• John Donofrio, MSW LCSW
• Joanne M Dooher, PT
• Rachel Dor, LMSW
• Christopher Doss, PT, DPT
• Eleni A Doulos, PT, DPT

• Clinical Psychologist in Great Neck, NY
• Providers in Great Neck, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; 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.