KELLY PETRINO, PSYD (NPI# 1548656523) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548656523 |
| Entity Type | Organization |
| Organization Name | KELLY PETRINO, PSYD |
| Practice Address |
507 S 4th St Laramie WY 82070-3753 |
| Practice Telephone | 3074600781 |
| Practice Fax Number | 3077424089 |
| Mailing Telephone | 3074600781 |
| Mailing Fax Number | 3077424089 |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2015-04-07 |
| Authorized Official Name | DR. KELLY PETRINO (PSYCHOLOGIST/OWNER) |
| Authorized Official Telephone | 3074600781 |
| Authorized Official Credential | PSYD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC1900X |
Psychologist Specialization: Counseling |
505 | WY | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | 151943 | 05 |
| Street Address |
507 S 4TH ST |
| City | LARAMIE |
| State | WY |
| Zip Code | 82070-3753 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609277227 | Emily Siegel, Lcsw PC | Social Worker | 507 S 4th St, Laramie, WY 82070-3753 | 2014-09-15 |
| 1861824203 | Stephanie Joyce Hanson | Counselor | 507 S 4th St, Laramie, WY 82070-3753 | 2013-08-08 |
| 1255675815 | Tara Clapp | Psychologist | 507 S 4th St, Laramie, WY 82070-3753 | 2012-11-20 |
| 1639328040 | Anne C Bunn Phd LLC | Psychologist | 507 S 4th St, Suite B, Laramie, WY 82070-3753 | 2008-09-10 |
| 1174798375 | Cynthia M Hartung | Psychologist | 507 S 4th St, Suite A, Laramie, WY 82070-3753 | 2008-04-28 |
| 1871717306 | Gay Deitrich-maclean PC | Psychologist | 507 S 4th St, Suite B, Laramie, WY 82070-3729 | 2007-04-13 |
| 1003030511 | Vivian Gay Deitrich-maclean | Psychologist | 507 S 4th St, Suite B, Laramie, WY 82070-3729 | 2007-04-13 |
| 1437277910 | Gillian Emily Siegel | Social Worker | 507 S 4th St, Laramie, WY 82070-3753 | 2007-03-26 |
| 1871652248 | Douglas John Scambler | Psychologist | 507 S 4th St, Suite A, Laramie, WY 82070-3753 | 2006-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548875164 | Roland Maldonado | Registered Nurse | 258 Nth Hayes Street, Laramie, WY 82070 | 2020-09-10 |
| 1528429917 | Spark | Community/Behavioral Health | 903 S 9th Street, Laramie, WY 82070 | 2016-03-11 |
| 1578968509 | Melissa Marie Allen | Speech-Language Pathologist | 1613 Clydesdale, Laramie, WY 82070 | 2014-11-04 |
| 1316362155 | Charles M. Alexander | Pharmacist | 3112 E. Grand Ave, Laramie, WY 82070 | 2014-03-04 |
| 1447685706 | Dale Warren Van Wig | Pharmacist | 544 N. Third St, Pharmacy, Laramie, WY 82070 | 2013-09-05 |
| 1558619973 | Sarah Marie Pence | Pharmacist | 4005 East Grand Ave, Laramie, WY 82070 | 2012-08-15 |
| 1437435567 | Stephanie Ingalls | Case Manager/Care Coordinator | 69 Osprey Rd., Laramie, WY 82070 | 2011-11-03 |
| 1457634040 | The Clinic for Mental Health and Wellness | Counselor | 504 South 4th Street, Laramie, WY 82070 | 2011-09-21 |
| 1316177371 | Patricia Ann Casey | Occupational Therapist | Laramie Care Center, 503 S. 18th St., Laramie, WY 82070 | 2009-07-23 |
| 1134322340 | Linda K Cross | Case Manager/Care Coordinator | 315 So 8th, Laramie, WY 82070 | 2007-06-06 |
| Find all providers in zip 82070 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598389827 | Julio Brionez | Psychologist | 1115 1/2 Steele Street, Laramie, WY 82070-4661 | 2020-06-02 |
| 1487709119 | Ronald L Sprinkle | Psychologist | 1277 N 15th St, Laramie, WY 82072-2343 | 2007-01-24 |
| 1760588271 | Kelly Lynne Pendley | Psychologist | 1277 N 15th St, Laramie, WY 82072-2343 | 2006-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235356288 | Donald Howard Benson | Psychologist | 3437 Stagecoach Dr, Casper, WY 82604-5445 | 2007-04-19 |
| 1225115561 | Mark Tanner Gibson | Psychologist | 175 River View Dr, Green River, WY 82935-4811 | 2006-11-01 |
| 1215928965 | Kim Knox Faulkner | Psychologist | 135 Pine Street, Suite B, Buffalo, WY 82834-2332 | 2005-11-02 |
| 1518206465 | Action Life Services, LLC | Psychologist | 963 Fort St, #4, Buffalo, WY 82834-2424 | 2013-02-12 |
| 1477707321 | Sheri J Fluellen | Psychologist | 719 E 17th St, Cheyenne, WY 82001-4711 | 2008-11-05 |
| 1184802175 | Cheryl A Godley | Psychologist | 1607 Cy Ave, Suite 302, Casper, WY 82604-3572 | 2008-02-01 |
| 1073536801 | Kurt P Benson | Psychologist | 1898 Fort Road, Sheridan Va Medical Center, Sheridan, WY 82807 | 2006-07-25 |
| 1992748552 | Hollis W Hackman | Psychologist | 1898 Fort Rd, Sheridan, WY 82801-8320 | 2006-06-13 |
Please comment or provide details below to improve the information on KELLY PETRINO, PSYD.
| 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.