Dr. Kelly L. Irvine
Cognitive & Behavioral Psychologist
1000 W Nifong Blvd Bldg 6
Columbia
, Missouri 65203-5615
Dr. Kelly L. Irvine
Cognitive & Behavioral Psychologist
1000 W Nifong Blvd Bldg 6
Columbia
, Missouri 65203-5615
(660) 890-8156
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About
Features
Specialties
- Cognitive & Behavioral Psychologist
Languages spoken
- English
Location
First Address
- Dr. Kelly L. Irvine
- 1800 Community
- Clinton, MO
- Zip : 64735-8804
- Phone : (660) 890-8156
Second Address
- Dr. Kelly L. Irvine
- 1000 W Nifong Blvd Bldg 6
- Columbia, MO
- Zip : 65203-5615
- Phone : (888) 403-1071
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103TB0200X | Cognitive & Behavioral Psychologist | 2018042229 | MO |
National Provider Identifier
| NPI | 1134207269 |
|---|---|
| Provider Name | Dr. Kelly L. Irvine |
| First Address | Clinton, MO 64735-8804 |
| Second Address | Columbia, MO 65203-5615 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 02/11/2006 |
| Last Update Date | 28/08/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 116730 | BHN (01) | AZ |
| 141592 | (05) | LA |
| 2128566 | CIGNA (01) | AZ |
| 228289 | ONE HEALTH & GWL (01) | AZ |
| 291968 | MHN (01) | AZ |
| 4142 | CPQ (01) | |
| 415 | IA HSP # (01) | IA |
| 50583 | NRHSP IN PSYCH (01) | |
| 5457314 | FIRST HEALTH/CNN (01) | AZ |
| 75209 | (02) | AZ |
| 803925 | (05) | AZ |
| 86-1043861 | MAGELAN, BIODYNE, AETNA (01) | AZ |
| APA MEMBERSHIP # | 69103091 (01) | AZ |
| AZ0616050 | BC/BS (01) | AZ |
| NATIONAL REGISTER # | 50583 (01) | AZ |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.