Individual provider Active NPI

Kelly Anne Santandrea, PSY.D ABPP

  • Clinical Psychologist
  • Weston, FL
National Provider Identifier
1891385407
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY11005 Issued in FL
Practice address
1725 Main St Ste 223
Weston, FL 33326-3671
Phone
(786) 210-4266
NPI assigned
Jan 19, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY11005 FL Primary

Addresses

Primary practice location

1725 Main St Ste 223
Weston, FL 33326-3671

Mailing address

1725 Main St Ste 223
Weston, FL 33326-3671
Phone (754) 778-5705

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

State licenses

LicenseStateTypeSpecialty
PY11005FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ancora Psychological Institute LLC Clinical Current Accepting new patients
LDMS LLC Clinical PastSince Apr 3, 2022 Accepting new patients

Locations

1725 Main St
Ste 223
Weston, FL 33326
Phone (754) 778-5705

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1611014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1891385407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 MAIN ST STE 223",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333263671",
            "telephone_number": "754-778-5705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 MAIN ST STE 223",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333263671",
            "telephone_number": "786-210-4266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTANDREA",
        "first_name": "KELLY",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "PSY.D ABPP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-19",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY11005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.