DR. KELLEY HARRISON PISTACCHIO PH.D NPI 1780713735

NPI Information

NPI: 1780713735
Provider Name: DR. KELLEY HARRISON PISTACCHIO, PH.D
Classification: Psychologist - 103TP2701X
Specialization: Group Psychotherapy
Entity Type: Individual
PECOS Registration: Yes
Address: 610 MANTON AVE
PROVIDENCE, RI
ZIP 02909
Phone: (401) 274-6310

Map and Directions

Get Directions

NPI Details

DR. Kelley Harrison Pistacchio, PH.D is a group psychotherapy psychologist in Providence, RI. The provider is a psychologist who specializes in group psychology and group psychotherapy that is an evidenced-based specialty that prepares group leaders to identify and capitalize on developmental and healing possibilities embedded in the interpersonal/intrapersonal functioning of individual group members as well as collectively for the group. Emphasis is placed on the use of group dynamics to assist and treat individual group members. The specialty is applicable to all age groups, children, adolescents, adults and older adults, for a wide variety of conditions and concerns, and in numerous and diverse settings. DR. Kelley Harrison Pistacchio, PH.D NPI is 1780713735. 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:

610 MANTON AVE
PROVIDENCE, RI
ZIP 02909-633
Phone: (401) 274-6310
Fax: (401) 421-1977

The NPI 1780713735 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS).

The enumeration date for this NPI number is 3/5/2007 and was last updated on 9/11/2025.

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
1	103T00000X	Psychologist		PS00680	RHODE ISLAND	No
2	103TB0200X	Psychologist	Cognitive & Behavioral	PS00680	RHODE ISLAND	No
3	103TC0700X	Psychologist	Clinical	PS00680	RHODE ISLAND	No
4	103TC2200X	Psychologist	Clinical Child & Adolescent	PS00680	RHODE ISLAND	No
5	103TM1800X	Psychologist	Intellectual and Developmental Disabilities	PS00680	RHODE ISLAND	No
6	103TP2701X	Psychologist	Group Psychotherapy	PS00680	RHODE ISLAND	Yes

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
1	410468	OTHER	RHODE ISLAND	BLUE CHIP
2	KH29823	MEDICAID	RHODE ISLAND
3	30189-1	OTHER	RHODE ISLAND	BLUE CROSS
4	61-00006	OTHER	RHODE ISLAND	UNITED BEHAVIORAL HEALTH

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI

Next NPI