Active NPI
Caryn J Kennelly, PSY.D.
- Clinical Psychologist
- Lawrenceville, NJ
National Provider Identifier
1871779355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3997
- Practice address
- 2571 Main St
Lawrenceville, NJ 08648-1657 - Phone
- (609) 947-2116
- NPI assigned
- Jan 15, 2008
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3997 | NJ | Primary |
Addresses
Primary practice location
2571 Main St
Lawrenceville, NJ 08648-1657
Mailing address
247 Concord PL
Pennington, NJ 08534-5265
Phone (609) 947-2116
Other practice location 1
92 Nassau St
Princeton, NJ 08542-4530
Phone (609) 924-6294
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 052287 | Other | NJ | MEDICARE ID |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3997 | NJ | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clinical Psychassociates LLP | Clinical | Past | Accepting new patients |
| Princeton Center for Therapy & Assessment LLC | Past | Accepting new patients | |
| Princeton Center for Therapy and Assessment, LLC | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Psychologist
- Princeton, NJ
- NPI 1215354758
-
- Community/Behavioral Health Agency
- Princeton, NJ
- NPI 1548619711
-
- Clinical Psychologist
- New York, NY
- NPI 1124051925
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1871779355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "247 CONCORD PL",
"city": "PENNINGTON",
"state": "NJ",
"postal_code": "085345265",
"telephone_number": "609-947-2116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2571 MAIN ST",
"city": "LAWRENCEVILLE",
"state": "NJ",
"postal_code": "086481657",
"telephone_number": "609-947-2116"
}
],
"practiceLocations": [
{
"address_1": "92 Nassau St",
"address_purpose": "LOCATION",
"city": "Princeton",
"state": "NJ",
"postal_code": "085424530",
"country_code": "US",
"telephone_number": "609-924-6294",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KENNELLY",
"first_name": "CARYN",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-15",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NJ",
"license": "3997",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE ID",
"identifier": "052287",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceville, NJ
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.