KELLY WILLSON (NPI# 1467872309) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467872309 |
| Entity Type | Individual |
| Full Name | KELLY WILLSON |
| Credential | PH.D. |
| Practice Address |
738 Library Road Room 325 Rochester NY 14627-0472 |
| Practice Telephone | 5852753113 |
| Practice Fax Number | 5854420815 |
| Mailing Telephone | 5852753113 |
| Mailing Fax Number | 5854420815 |
| Enumeration Date | 2014-04-18 |
| Last Update Date | 2014-04-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
0188884-1 | NY | Behavioral Health & Social Service Providers |
| Street Address |
738 LIBRARY ROAD ROOM 325 |
| City | ROCHESTER |
| State | NY |
| Zip Code | 14627-0472 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518116243 | Ronke Lattimore Tapp | Psychologist | 738 Library Road, 3rd Flr University Counseling Center U of Rochester, Rochester, NY 14627-0356 | 2008-09-18 |
| 1881189819 | Megan Murray White | Psychologist | 738 Library Road, 3rd Floor, Rochester, NY 14627 | 2018-06-22 |
| 1205240835 | Ethan Nere Beaudett | Family Medicine | 738 Library Road, #1, Rochester, NY 14627-0617 | 2014-06-11 |
| 1619398690 | Arjan Berkeljon | Psychologist | 738 Library Road, Rochester, NY 14627-0356 | 2013-12-18 |
| 1316237613 | Dagmar R Kaufmann | Psychologist | 738 Library Road, University Counseling Center, University of Rochester, Rochester, NY 14627 | 2011-04-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578176749 | Harry Campbell | Specialist/Technologist | 500 Joseph C. Wilson Blvd., Rochester, NY 14627 | 2020-08-28 |
| 1992358907 | Audra Stickney | Dietitian, Registered | 783 Library Rd, Rochester, NY 14627 | 2019-07-18 |
| 1447328778 | Shauny Lynn Caruso | Specialist/Technologist | Goergen Athletic Center, University of Rochester, Rochester, NY 14627 | 2006-12-04 |
| 1063583011 | Patricia M. Mallon | Registered Nurse | University Counseling Center, Box 270356, Rochester, NY 14627 | 2006-11-13 |
| 1497795181 | Brigid M Cahill | Psychologist | Towne House 1325 Mt. Hope Ave, University Counseling Center, Rochester, NY 14627 | 2006-06-08 |
| 1578526778 | Angelo Zegarelli | Specialist/Technologist | 1163 Goergen Athletic Center, University of Rochester, Rochester, NY 14627 | 2006-04-10 |
| 1417050741 | Strong Memorial Hospital | General Acute Care Hospital | 601 Elmwood Ave, Rochester, NY 14627 | 2006-09-05 |
| 1801108741 | Orlando Omar Harris | Nurse Practitioner | 500 Joseph C Wilson Blvd, Rochester, NY 14627-0001 | 2010-07-08 |
| 1588952303 | Edward L Deci | Psychologist | 429 Meliora Hall, University of Rochester, Rochester, NY 14627-0266 | 2011-07-13 |
| 1588117550 | Eric Rozen | Specialist/Technologist | 601 Elmwood Avenue, Rochester, NY 14627-0296 | 2016-07-26 |
| Find all providers in zip 14627 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346883873 | Denise Pine | Psychologist | 1111 Elmwood Ave # D3, Rochester, NY 14620-3005 | 2019-10-28 |
| 1205305729 | Christopher Corona | Psychologist | 100 Linden Oaks, Suite 102, Rochester, NY 14625 | 2018-11-14 |
| 1275017550 | Leah Rothschild | Psychologist | 160 Allens Creek Rd Ste 160, Rochester, NY 14618-3312 | 2018-09-21 |
| 1639658693 | Garry Linsis Spink Jr. | Psychologist | 100 Pinewild Dr Fl 2, Rochester, NY 14606-4200 | 2018-08-10 |
| 1942798129 | Rachel Marie Rodorigo | Psychologist | 900 W University Dr Ste B3, Rochester, MI 48307-1817 | 2018-04-24 |
| 1740799162 | Douglas Andrew Raynor | Psychologist | 919 Winton Rd S Ste 106, Rochester, NY 14618-1633 | 2017-09-28 |
| 1356861884 | Lauren P Wadsworth | Psychologist | 21 Goodway Dr, Rochester, NY 14623-3029 | 2017-06-26 |
| 1881120947 | Dayton Walsh | Psychologist | 190 Goodman St S, Rochester, NY 14607-2651 | 2017-05-11 |
| 1770019713 | Brenna Cavanaugh | Psychologist | 200 East River Rd., Rochester, NY 14623 | 2017-05-11 |
| 1275068470 | Tara Marie Augenstein | Psychologist | University of Rochester, Dept. of Psychiatry, 300 Crittenden Blvd, Rochester, NY 14642 | 2017-04-25 |
| Find all providers in ROCHESTER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.