Dr Kelly Petrino, PSYD is a
Psychologist - Clinical based in Boise, Idaho. Dr Kelly Petrino is licensed to practice in Idaho (license number 203518) and her current practice location is
3350 W Americana Ter Ste 210, Boise, Idaho. She can be reached at her office (for appointments etc.) via phone at
(406) 880-5568.
NPI number for Dr Kelly Petrino is 1861784068 and her current mailing address is 3883 S Como Ave, Meridian, Idaho. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1861784068.
Healthcare Provider's Profile
| Full Name | Dr Kelly Petrino |
|---|
| Gender | Female |
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| Speciality | Psychologist - Clinical |
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| Location | 3350 W Americana Ter Ste 210, Boise, Idaho |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1861784068
- Provider Enumeration Date: 05/05/2011
- Last Update Date: 05/11/2022
Medical Identifiers
Medical identifiers for Dr Kelly Petrino such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1861784068 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | 18071 (Montana) | Secondary |
| 103T00000X | Psychologist | 505 (Wyoming) | Secondary |
| 103TC0700X | Psychologist - Clinical | 203518 (Idaho) | Primary |
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 Kelly Petrino is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Kelly Petrino, PSYD
3883 S Como Ave,
Meridian, ID 83642-1446
Ph: (406) 880-5568 | Dr Kelly Petrino, PSYD
3350 W Americana Ter Ste 210,
Boise, ID 83706-2546
Ph: (406) 880-5568 |
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