DR. KELLY ELIZABETH KOLLIAS (NPI# 1871978833) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871978833 |
| Entity Type | Individual |
| Full Name | DR. KELLY ELIZABETH KOLLIAS |
| Credential | PSY.D. |
| Practice Address |
3900 Church Road Bancroft Neurorehab Mount Laurel NJ 08054-9999 |
| Mailing Address |
1 Harrowgate Ct Marlton NJ 08053-4503 |
| Practice Telephone | 8565247412 |
| Practice Fax Number | 8562169240 |
| Mailing Telephone | 6102471442 |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2015-11-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 35SI00547700 | NJ | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
35SI00547700 | NJ | Behavioral Health & Social Service Providers |
| Street Address |
3900 CHURCH ROAD BANCROFT NEUROREHAB |
| City | MOUNT LAUREL |
| State | NJ |
| Zip Code | 08054-9999 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023288925 | Kim Butterworth | Speech-Language Pathologist | 3900 Church Road, Mount Laurel, NJ 08054-1108 | 2008-03-06 |
| 1871975540 | Bancroft | Clinic/Center | 3900 Church Road, Mount Laurel, NJ 08054 | 2015-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841837267 | Samantha Leafey | Behavior Technician | 800 Birchfield Dr., 801, Mount Laurel, NJ 08054 | 2019-12-04 |
| 1306403522 | A-1 Support Coordination Nj | Case Management | 1504 Larchmont Place, Mount Laurel, NJ 08054 | 2019-05-22 |
| 1285129080 | Lincoln Healthcare of New Jersey, LLC | Home Health | 309 Fellowship Rd Ste 100, Mount Laurel, NJ 08054 | 2018-06-25 |
| 1295238400 | Verus Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 200 E Park Dr Ste 600a, Mount Laurel, NJ 08054 | 2018-03-14 |
| 1003323387 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 73 Fellowship, Mt Laurel, NJ 08054 | 2018-01-08 |
| 1750893954 | Tishanna D Majette Phd Corporation | Psychologist | 3000 Atrium Way Ste 200, Mount Laurel, NJ 08054 | 2017-10-27 |
| 1700304706 | Arc of Camden County Essex Lane Supported Living | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5320 Essex Lane, Mt. Laurel, NJ 08054 | 2017-08-30 |
| 1417472861 | Maggie Garin | Dietitian, Registered | 15000 Midlantic Avenue, Suite 101, Mount Laurel, NJ 08054 | 2017-08-07 |
| 1891225363 | New Jersey Lice Treatment LLC | Technician, Other | 500 Birchfield Dr, Suite 503-a, Mount Laurel, NJ 08054 | 2017-06-15 |
| 1225563927 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 761 Grant Ave, Mt Laurel, NJ 08054 | 2017-05-01 |
| Find all providers in zip 08054 | ||||
| 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 |
|---|---|---|---|---|
| 1780722769 | Claire Mcgrath | Clinical Neuropsychologist | 3900 Church Rd, Mount Laurel, NJ 08054-1108 | 2007-02-02 |
| 1770851883 | Danielle Nicole Ager | Clinical Neuropsychologist | 3900 Church Rd, Mount Laurel, NJ 08054 | 2011-12-03 |
| 1720121106 | Bancroft Neurohealth | Clinical Neuropsychologist | 3900 Church Rd, Mount Laurel, NJ 08054 | 2007-02-15 |
| 1801991658 | John R Mcgowan | Clinical Neuropsychologist | 3829 Church Rd, Mount Laurel, NJ 08054-1105 | 2006-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437791993 | Dig It | Clinical Neuropsychologist | 5 Elm Ln, Rumson, NJ 07760-1001 | 2019-10-16 |
| 1255981767 | Brian Schopfer | Clinical Neuropsychologist | 792 Chimney Rock Rd Ste C, Martinsville, NJ 08836-2271 | 2019-09-17 |
| 1750866869 | Anjuli Bodapati | Clinical Neuropsychologist | 608 Sherwood Pkwy Ste 2d, Mountainside, NJ 07092 | 2018-09-25 |
| 1619496908 | Hilary F Murphy | Clinical Neuropsychologist | 1451 State Route 34 Ste 201, Wall Township, NJ 07727-1614 | 2017-09-18 |
| 1841653763 | Andrew P Brown IIi | Clinical Neuropsychologist | 31 Clinton St, Newark, NJ 07102-3729 | 2016-03-29 |
| 1053789230 | Lisa Hahn | Clinical Neuropsychologist | 916 Maple Ave, Newton, NJ 07860-4404 | 2015-09-04 |
| 1700264256 | Barbara Lauer Listhaus, Psy. D., LLC | Clinical Neuropsychologist | 513 W Mount Pleasant Ave Ste 210, Livingston, NJ 07039-1721 | 2015-05-15 |
| 1295128882 | Anne Romyr Denor | Clinical Neuropsychologist | 30 John St Apt 2c, Bloomfield, NJ 07003-5142 | 2015-03-06 |
| 1811304660 | Mallory Seidman | Clinical Neuropsychologist | 16 Inness Pl, Montclair, NJ 07042-4923 | 2014-07-14 |
| 1811325152 | Amy L. Hradil | Clinical Neuropsychologist | 2048 Oak Tree Road Center for Head Injuries, Cognitive Rehabilitation Progr, Edison, NJ 08820 | 2013-10-24 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT LAUREL |
| Zip Code | 08054 |
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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.