SHAYNE KELLY MA PSYD NPI 1124906771

NPI Information

  • NPI: 1124906771
  • Provider Name: SHAYNE KELLY, MA, PSYD
  • Classification: Student in an Organized Health Care Education/Training Program - 390200000X
  • Entity Type: Individual
  • Address: 400 E SOUTH WATER ST APT 3201
    CHICAGO, IL
    ZIP 60601
  • Phone: (224) 639-0167

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NPI Details

Shayne Kelly, MA, PSYD is a student in an organized health care education training program in Chicago, IL. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Shayne Kelly, MA, PSYD NPI is 1124906771. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

400 E SOUTH WATER ST APT 3201
CHICAGO, IL
ZIP 60601-072
Phone: (224) 639-0167

The enumeration date for this NPI number is 8/22/2025 and was last updated on 8/22/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1390200000XStudent in an Organized Health Care Education/Training ProgramYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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