Kelly Elizabeth Kollias, PSY.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

35SI00547700 Issued in NJ

Practice address

3900 Church Road
Bancroft Neurorehab
Mount Laurel, NJ 08054-9999

Phone

(856) 524-7412

Fax

(856) 216-9240

NPI assigned

Jul 20, 2015

Last updated

Nov 23, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Aaa Neuropsychology, LLCGroup PAC ID 8022250166, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aaa Neuropsychology, LLC

  • Clinical Psychologist
  • Malvern, PA
  • NPI 1053744201
  Medicare reassignment Care Compare group NPD
• Neuropsychological Assessment and Therapy Services, LLC

  • Clinical Neuropsychologist
  • Berwyn, PA
  • NPI 1104202902
  NPD (past)

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

{
    "created_epoch": "1437350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448236800000",
    "number": "1871978833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HARROWGATE CT",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534503",
            "telephone_number": "610-247-1442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 CHURCH ROAD",
            "address_2": "BANCROFT NEUROREHAB",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080549999",
            "telephone_number": "856-524-7412",
            "fax_number": "856-216-9240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLIAS",
        "first_name": "KELLY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-20",
        "last_updated": "2015-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NJ",
            "license": "35SI00547700",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00547700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim F Klaus, LPC
• Frederick Boyd Klinger III, D.O.
• Andrew Gerard Knasiak, PHARMD
• Marcia Koetting
• Maria Z Kokolis
• Michael Koplin, DMD
• Melissa Kopytko, CRNP
• Saika S Korleh
• James C. Koss, M.D.
• Kelly Scott Kover, MPT, OCS

• Clinical Neuropsychologist in Mount Laurel, NJ
• Providers in Mount Laurel, NJ by specialty
• Clinical Neuropsychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2015; 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.
• Medicare Care Compare (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.