Kelley Callahan, PSY.D – Psychologist

Key facts

NPI: 1780906206
Entity type: Individual (NPI type 1)
Primary specialty: Psychologist 103T00000X
License: 4466 (OH)
Practice address: 212 E Main St
Greenville, OH 45331-1913
Phone: (937) 548-1635
Fax: (937) 548-1500
NPI assigned: Feb 25, 2010
Sex: Female
Sole proprietor: No

Organizations & group practices 1

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.

Layh & Associates Inc Clinical Psychologist · Yellow Springs, OH · NPI 1437176492

Medicare reassignment Care Compare group NPD OH

Medicare Care Compare profile

Specialty: Clinical Psychologist
Education: Other, 1990
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Layh and Associates Inc (15 clinicians)

Practice addresses (Care Compare)

416 Xenia Ave
Yellow Springs, OH 45387-1836
Phone (937) 767-9171

Medicare participation

Medicare fee-for-service enrollment: Enrolled in OH
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20231213001009	OH	Practitioner - Clinical Psychologist	6204285455	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
4466	OH	MD	Psychologist

Practice roles

Organization	Specialty	Status	New patients
Layh & Associates Inc		Current since Nov 1, 2023	Accepting new patients

Locations

416 Xenia Ave
Yellow Springs, OH 45387
Phone (937) 767-9171

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Psychologist	103T00000X	4466	OH	Yes

Addresses

Primary practice location

212 E Main St
Greenville, OH 45331-1913

Mailing address

PO Box 895
212 East Main Street
Greenville, OH 45331
Phone (937) 548-1635

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 20, 2020.

{
    "created_epoch": "1267056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1780906206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 895",
            "address_2": "212 EAST MAIN STREET",
            "city": "GREENVILLE",
            "state": "OH",
            "postal_code": "45331",
            "telephone_number": "937-548-1635",
            "fax_number": "937-548-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 E MAIN ST",
            "city": "GREENVILLE",
            "state": "OH",
            "postal_code": "453311913",
            "telephone_number": "937-548-1635",
            "fax_number": "937-548-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "KELLEY",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-25",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "4466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, OH

All providers in Greenville, OH · Psychologist in Ohio

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 20, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.