KATHLEEN REILLY NPI 1417659962

NPI Information

  • NPI: 1417659962
  • Provider Name: KATHLEEN REILLY
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 194 WATERMAN ST
    PROVIDENCE, RI
    ZIP 02906
  • Phone: (401) 633-2929

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NPI Details

Kathleen Reilly is a psychiatric/mental health nurse practitioner in Providence, RI with 3 years of experience. Kathleen Reilly NPI is 1417659962. 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:

194 WATERMAN ST
PROVIDENCE, RI
ZIP 02906-015
Phone: (401) 633-2929
Fax: (888) 602-6957

The NPI 1417659962 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/20/2023 and was last updated on 12/27/2023.

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
1101YM0800XCounselorMental HealthNo
2363LP0808XNurse PractitionerPsychiatric/Mental HealthAPRN03630RHODE ISLANDYes

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

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