Kelly Ann Mendonca, PSY.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

P92114 Issued in NY

Practice address

483 Clermont Ave
3Rd Floor
Brooklyn, NY 11238-2253

Phone

(718) 643-5300

NPI assigned

May 23, 2008

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Carl Fenichel Community Services

  dba Carl Fenichel Community SVCS Day

  • Developmentally Disabled Services Day Training Agency
  • Brooklyn, NY
  • NPI 1790965655
  NPD (past)
• League School

  • Local Education Agency (LEA)
  • Brooklyn, NY
  • NPI 1770771685
  NPD (past)

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

{
    "created_epoch": "1211500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414108800000",
    "number": "1972761195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 CLERMONT AVE",
            "address_2": "3RD FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112382253",
            "telephone_number": "718-643-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 CLERMONT AVE",
            "address_2": "3RD FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112382253",
            "telephone_number": "718-643-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDONCA",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-23",
        "last_updated": "2014-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "001641-1",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "P92114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Mendlowitz, MSED
• Cassandra Mendola
• Leonard Richard Mendola, PH.D.
• Matthew Loenard Mendola
• Donna Mendonca, DNP
• Franz Chartier Mendoza Garcia
• Roscelin Yisleni Mendoza Savinon
• Amanda Mendoza
• Arthur Pablo Mendoza, PT
• Carlisdania Mendoza, M.D.

• Clinical Child & Adolescent Psychologist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinical Child & Adolescent Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; 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.