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KEVIN THOMAS KELLY PH.D. NPI 1508059080


NPI Information

NPI: 1508059080
Provider Name: KEVIN THOMAS KELLY, PH.D.
Classification: Psychologist - 103T00000X
Entity Type: Individual
Address:
598 COCHRANE AVE
UKIAH, CA
ZIP 95482
Phone: (707) 463-1447
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Kevin Thomas Kelly, PH.D. is a psychologist in Ukiah, CA. The provider is a psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. Kevin Thomas Kelly, PH.D. NPI is 1508059080. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

598 COCHRANE AVE
UKIAH, CA
ZIP 95482-621
Phone: (707) 463-1447
Fax: (866) 204-9690

The enumeration date for this NPI number is 8/20/2007 and was last updated on 8/20/2007.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103T00000XPsychologistPSY9275CALIFORNIAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1#00PL92750OTHERCALIFORNIABLUE SHIELD SUBMITTER
2PA0092759OTHERCALIFORNIAMEDI-CAL
300PL92750MEDICARE UPINCALIFORNIA
4PSY00009275OTHERCALIFORNIABLUE CROSS
5A00PL92750OTHERCALIFORNIABLUE SHIELD UIC #
67809105OTHERCALIFORNIABLUE CROSS PIN

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: 4/28/2024

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