Pistacchio, Kelley Harrison

Pistacchio, Kelley Harrison is an individual health care provider with primary practice located at 610 Manton Ave , Providence RI 02909-5633. She recently has 6 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities, Behavioral Health & Social Service Providers / Group Psychotherapy. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Pistacchio, Kelley Harrison can be contacted via phone (401) 274-6310.

Contact Information

Primary practice address
610 Manton Ave Providence RI 02909-5633
Phone: (401) 274-6310
Fax: (401) 421-1977
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X PS00680 Rhode Island
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X PS00680 Rhode Island
Behavioral Health & Social Service Providers / Clinical 103TC0700X PS00680 Rhode Island
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X PS00680 Rhode Island
Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities 103TM1800X PS00680 Rhode Island
Behavioral Health & Social Service Providers / Group Psychotherapy 103TP2701X PS00680 Rhode Island

Profile Details

NPI number 1780713735
LBN Legal business name Pistacchio, Kelley Harrison
Credentials PH.D
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 5th, 2007
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780713735 NPPES
Rhode Island Other 410468 BLUE CHIP
Rhode Island MEDICAID KH29823 BLUE CHIP
Rhode Island Other 30189-1 BLUE CHIP
Rhode Island Other 61-00006 BLUE CHIP

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