DR. SHANNON KELLY PSY.D. NPI 1457313330

NPI Information

  • NPI: 1457313330
  • Provider Name: DR. SHANNON KELLY, PSY.D.
  • Classification: Psychologist - 103TH0100X
  • Specialization: Health Service
  • Entity Type: Individual
  • Address: 6001 BRICK CT
    SUITE 201
    WINTER PARK, FL
    ZIP 32792
  • Phone: (407) 671-1123

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NPI Details

DR. Shannon Kelly, PSY.D. is a health service psychologist in Winter Park, FL. The provider is a psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974). DR. Shannon Kelly, PSY.D. NPI is 1457313330. 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:

6001 BRICK CT
SUITE 201
WINTER PARK, FL
ZIP 32792-425
Phone: (407) 671-1123
Fax: (407) 671-1233

The enumeration date for this NPI number is 4/5/2006 and was last updated on 7/8/2007.

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
1103TH0100XPsychologistHealth ServicePY7017FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
174434ZMEDICARE ID-TYPE UNSPECIFIEDFLORIDA

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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