Active NPI
Jennifer Kelly, PSYD
- Psychologist
- Bronxville, NY
National Provider Identifier
1750791257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 021862
- Practice address
- 11 Brooklands Apt Gi
Bronxville, NY 10708-3512 - Phone
- (646) 775-8276
- Fax
- (646) 775-8276
- NPI assigned
- May 6, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 021862 | NY | Primary |
Addresses
Primary practice location
11 Brooklands Apt Gi
Bronxville, NY 10708-3512
Mailing address
11 Brooklands Apt Gi
Bronxville, NY 10708-3512
Phone (646) 775-8276
Other practice location 1
1493 Cambridge Street
Cambridge Health Alliance
Cambridge, MA 02139
Phone (617) 665-1183
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1750791257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 BROOKLANDS APT GI",
"city": "BRONXVILLE",
"state": "NY",
"postal_code": "107083512",
"telephone_number": "646-775-8276"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 BROOKLANDS APT GI",
"city": "BRONXVILLE",
"state": "NY",
"postal_code": "107083512",
"telephone_number": "646-775-8276",
"fax_number": "646-775-8276"
}
],
"practiceLocations": [
{
"address_1": "1493 Cambridge Street",
"address_2": "Cambridge Health Alliance",
"address_purpose": "LOCATION",
"city": "Cambridge",
"state": "MA",
"postal_code": "02139",
"country_code": "US",
"telephone_number": "617-665-1183",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KELLY",
"first_name": "JENNIFER",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-05-06",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "021862",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronxville, NY
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.