Kellee Rae Clougherty, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

G79391 Issued in CA

Practice address

21632 Wesley Dr
Laguna Beach, CA 92651-8167

Phone

(949) 499-5346

NPI assigned

Jun 27, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Loyola University of Chicago, Stritch School of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Integrated Psychological Services a Professional Corporation

  • Group Psychotherapy Psychologist
  • Laguna Niguel, CA
  • NPI 1588639918
  NPD
• County of Orange

  dba AMHS Crisis Stabilization Unit

  • Adult Mental Health Clinic/Center
  • Santa Ana, CA
  • NPI 1598025793
  NPD (past)
• County of Orange

  dba CYS South Region Wesley

  • Adolescent and Children Mental Health Clinic/Center
  • Laguna Beach, CA
  • NPI 1730226556
  NPD (past)

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1962439661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30101 TOWN CENTER DR STE 216",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926772065",
            "telephone_number": "805-798-5100",
            "fax_number": "949-388-5125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21632 WESLEY DR",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926518167",
            "telephone_number": "949-499-5346"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30101 Town Center Dr Ste 216",
            "address_purpose": "LOCATION",
            "city": "Laguna Niguel",
            "state": "CA",
            "postal_code": "926772065",
            "country_code": "US",
            "telephone_number": "805-798-5100",
            "fax_number": "949-388-5125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLOUGHERTY",
        "first_name": "KELLEE",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "G79391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clark Dentistry, Professional Corporation
• Rebecca Lynne Clark Mane, LMFT
• William B Clark, DDS
• Kassie Claughton, LCSW
• David N Cler, O.D.
• Kristen Clute
• Coast Concierge Medicine Inc
• Coast to Coast Referral Center, Inc.
• Coastal Endocrinology Inc
• Coastal Integrative Medicine

• Child & Adolescent Psychiatry Physician in Laguna Beach, CA
• Providers in Laguna Beach, CA by specialty
• Child & Adolescent Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; 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.