DR. KELLY LYNN PEARCE (NPI# 1780809020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1780809020 |
Entity Type | Individual |
Full Name | DR. KELLY LYNN PEARCE |
Credential | PH.D. |
Practice Address |
1622 South Ave W Missoula MT 59801-7804 |
Practice Telephone | 4065439700 |
Mailing Telephone | 4065439700 |
Enumeration Date | 2007-04-13 |
Last Update Date | 2016-06-10 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103G00000X | Clinical Neuropsychologist | PSY-PSY-LIC-1734 | MT | Behavioral Health & Social Service Providers |
N | 103T00000X | Psychologist | PSY-PSY-LIC-1734 | MT | Behavioral Health & Social Service Providers |
N | 103TC0700X |
Psychologist Specialization: Clinical |
PSY-PSY-LIC-1734 | MT | Behavioral Health & Social Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184022055 | Kelly Ryan Pearce | Counselor | 502 Peace Haven Rd, Kannapolis, NC 28083-6957 | 2014-12-09 |
Street Address |
1622 SOUTH AVE W |
City | MISSOULA |
State | MT |
Zip Code | 59801-7804 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285685800 | Robert Velin | Clinical Neuropsychologist | 1622 South Ave W, Missoula, MT 59801-7804 | 2006-05-16 |
1417318023 | Montana Neuropsychological Associates, Pllc | Psychologist | 1622 South Ave W, Missoula, MT 59801-7804 | 2016-03-09 |
1770525115 | Mendy Bucy | Social Worker | 1622 South Ave W, Third Floor, Missoula, MT 59801-7804 | 2006-06-11 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629681010 | Time To Thrive Pllc | Social Worker | 1836 South Ave. West, Missoula, MT 59801 | 2020-08-26 |
1740815653 | Yuzo Fujiki | Specialist/Technologist | 210 N California St 104, Missoula, MT 59801 | 2020-03-11 |
1407346596 | Stepping Stones Counseling, Pllc | Counselor | 202 Brooks St Ste 300, Missoula, MT 59801 | 2018-05-14 |
1437668530 | Rejuve Care Clinic, Inc | Plastic Surgery | 715 Kensingten, Ste 1, Missoula, Missoula, MT 59801 | 2017-09-21 |
1619499555 | Beatrice Elise Powers | Specialist/Technologist | 410 B Stephens Ave, Missoula, MT 59801 | 2017-07-12 |
1770012197 | Hannah Lepiane | Massage Therapist | 1313 S. 4th W., Missoula, MT 59801 | 2017-06-08 |
1811420227 | Celeste Willis | Social Worker | 1055 W. Sussex, Missoula, MT 59801 | 2017-04-04 |
1073050498 | Rina Kasuga | Specialist/Technologist | 913 Rimini Ct, Missoula, MT 59801 | 2017-01-24 |
1043756919 | Heather Bartz | Specialist/Technologist | 831 Hastings Ave, Missoula, MT 59801 | 2017-01-16 |
1255874517 | Sarabeth Haddad | Social Worker | 1055 W Sussex Ave, Missoula, MT 59801 | 2016-11-18 |
Find all providers in zip 59801 |
Taxonomy Code | 103G00000X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Clinical Neuropsychologist |
An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780055640 | Craig Mcfarland | Clinical Neuropsychologist | 313 E Beckwith Ave, Missoula, MT 59801-5838 | 2015-10-16 |
1346273968 | Montana Neurocare Pllc | Clinical Neuropsychologist | 2825 Fort Missoula Rd Ste 301, Missoula, MT 59804-7403 | 2006-07-08 |
1285685800 | Robert Velin | Clinical Neuropsychologist | 1622 South Ave W, Missoula, MT 59801-7804 | 2006-05-16 |
1255679411 | Robert Stuart Hall | Clinical Neuropsychologist | 1444 Mansfield Ave, Missoula, MT 59812-0001 | 2013-01-23 |
1063797686 | Bria A Dunkin | Clinical Neuropsychologist | 601 W Spruce St Ste K, Missoula, MT 59802-4047 | 2011-10-14 |
1245400787 | William D. Patenaude, Phd PC | Clinical Neuropsychologist | 125 Bank St Ste 310, Missoula, MT 59802-4413 | 2008-03-11 |
1326174566 | Jacqueline Day | Clinical Neuropsychologist | 1001 Sw Higgins Ave, Suite 207, Missoula, MT 59803-1341 | 2007-02-24 |
1386793289 | Patricia Lee Webber | Clinical Neuropsychologist | 1001 Sw Higgins Ave, Suite 207, Missoula, MT 59803-1341 | 2007-01-09 |
1295750636 | John Robert Harrison | Clinical Neuropsychologist | 2825 Fort Missoula Rd, Ste 301, Missoula, MT 59804-7403 | 2006-07-13 |
1649227059 | Paul Bach | Clinical Neuropsychologist | 900 N Orange St, Third Floor, Missoula, MT 59802-2998 | 2006-05-30 |
Find all providers in MISSOULA |
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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.