Dr Kelley Harrison Pistacchio, PHD in Providence, RI

Dr Kelley Harrison Pistacchio, PHD is a medicare enrolled "Psychologist - Group Psychotherapy" provider in Providence, Rhode Island. Her current practice location is 610 Manton Ave, Providence, Rhode Island. You can reach out to her office (for appointments etc.) via phone at (401) 274-6310.

Dr Kelley Harrison Pistacchio is licensed to practice in Rhode Island (license number PS00680) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1780713735.

Contact Information

	Dr Kelley Harrison Pistacchio, PHD
	610 Manton Ave, Providence, RI 02909-5633
	(401) 274-6310
	(401) 421-1977

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Kelley Harrison Pistacchio
Gender	Female
Speciality	Psychologist - Group Psychotherapy
Location	610 Manton Ave, Providence, Rhode Island
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1780713735
Provider Enumeration Date: 03/05/2007
Last Update Date: 07/09/2007

Medicare PECOS Information:

PECOS PAC ID: 6901099795
Enrollment ID: I20101026000473

Medical Identifiers

Medical identifiers for Dr Kelley Harrison Pistacchio such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1780713735	NPI	-	NPPES
410468	Other	RI	BLUE CHIP
KH29823	Medicaid	RI
30189-1	Other	RI	BLUE CROSS
61-00006	Other	RI	UNITED BEHAVIORAL HEALTH

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103T00000X	Psychologist	PS00680 (Rhode Island)	Primary
103TB0200X	Psychologist - Cognitive & Behavioral	PS00680 (Rhode Island)	Primary
103TC0700X	Psychologist - Clinical	PS00680 (Rhode Island)	Primary
103TC2200X	Psychologist - Clinical Child & Adolescent	PS00680 (Rhode Island)	Primary
103TM1800X	Psychologist - Intellectual & Developmental Disabilities	PS00680 (Rhode Island)	Primary
103TP2701X	Psychologist - Group Psychotherapy	PS00680 (Rhode Island)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Kelley Harrison Pistacchio allows following entities to bill medicare on her behalf.

Entity Name	The Groden Center,inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1336297902 PECOS PAC ID: 6204029093 Enrollment ID: O20101025001371

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kelley Harrison Pistacchio is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Kelley Harrison Pistacchio, PHD 122 Jane St, North Providence, RI 02904-4957 Ph: (401) 274-6310	Dr Kelley Harrison Pistacchio, PHD 610 Manton Ave, Providence, RI 02909-5633 Ph: (401) 274-6310

Reviews and Comments

Psychologist in Providence, RI

Julie Elizabeth Morris, PHD Psychologist Medicare: Medicare Enrolled Practice Location: 146 W River St, Suite 11a, Providence, RI 02904 Phone: 401-793-8770 Fax: 401-793-8709
Alexandrea L Craft, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 50 Holden St, Providence, RI 02908 Phone: 401-453-7640 Fax: 401-453-7646
Dr. Livia Freier, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 38 N Court St, Providence, RI 02903 Phone: 401-484-7050
Debra J Lobato-barrera, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1 Hoppin St, Suite 204, Providence, RI 02903 Phone: 401-444-8945 Fax: 401-444-8742
Mrs. Gladys V Rezendes, MSW LICSW Psychologist Medicare: Not Enrolled in Medicare Practice Location: 118 Comstock Avenue, Providence, RI 02907 Phone: 401-621-5882 Fax: 501-621-8463
Mrs. Rhonda L Sabo, PSY.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 341 Broadway, Providence, RI 02909 Phone: 401-453-5100
Dr. Andrew Jonah Taytslin, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1 Richmond Sq Ste 300e, Providence, RI 02906 Phone: 401-349-3131

Dr Kelley Harrison Pistacchio, PHD - Medicare Psychologist in Providence, RI