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Individual

DR. KELLY L. IRVINE

Active
Find providers by NPI
Individual

DR. KELLY L. IRVINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSYD

Taxonomy

Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
2018042229
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
116730
BHN
AZ
05
141592
LA
01
2128566
CIGNA
AZ
01
228289
ONE HEALTH & GWL
AZ
01
291968
MHN
AZ
01
4142
CPQ
01
415
IA HSP #
IA
01
50583
NRHSP IN PSYCH
01
5457314
FIRST HEALTH/CNN
AZ
05
803925
AZ
01
86-1043861
MAGELAN, BIODYNE, AETNA
AZ
01
APA MEMBERSHIP #
69103091
AZ
01
AZ0616050
BC/BS
AZ
01
NATIONAL REGISTER #
50583
AZ
Enumeration date
11/02/2006
Last updated
08/28/2019
Update your record

If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.

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