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DR. KELLY L NICHOLSON PSY.D.
NPI 1043424807
Psychologist - Clinical in Castle Rock, CO

Active since May 10, 2007PECOS EnrolledAccepts Medicare Assignment
1605 MOONSTONE LN, CASTLE ROCK, CO 80108(720) 588-6772 Get Directions Write a Review

NPPES record last updated: August 21, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Kelly L Nicholson Psy.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KELLY L NICHOLSON PSY.D. (NPI 1043424807) is an individual clinical provider in Castle Rock, Colorado, licensed in South Carolina (1340) and active in the NPI registry since May 2007. She is enrolled in Medicare PECOS and is a graduate of Other (2006).

NPPES Registry Identity

NPI1043424807
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. KELLY L NICHOLSONCredential: PSY.D.
Location Address1605 MOONSTONE LNCastle Rock, CO 80108-7809
Mailing Address22 Redbud WayBluffton, SC 29910-5605 · (843) 226-6690
Phone(720) 588-6772
Sole ProprietorYes
Medical School CMSOtherGraduated 2006
Enumeration DateMay 10, 2007
Last NPPES UpdateAugust 21, 2015
✔ NPI 1043424807 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
Licenses✔ Licensed in SC · 1340✔ Licensed in CO · 3154
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
1605 MOONSTONE LN, Castle Rock, CO 80108
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Kelly L Nicholson Psy.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9931239191
PECOS Enrollment IDI20150302001596
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychotherapy, 1 hour 90837
Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 1-hour session, you'll talk about your feelings, thoughts, and behaviors to help identify and manage mental health issues. This process aids in personal growth, healing, and improved well-being.
385 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 80108 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$174.82 typical visit price
range $58.06 – $174.82
Typical copayment $43.70 (range $14.51 – $43.70)
Most-billed visit code 99205
Established Patient
$102.03 typical visit price
range $18.88 – $142.79
Typical copayment $25.50 (range $4.72 – $35.69)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Nicholson's NPI number?

The NPI number for Kelly Nicholson is 1043424807. It was assigned to this individual provider in the NPPES registry on May 10, 2007.

Where is Kelly Nicholson located?

Kelly Nicholson practices at 1605 Moonstone Ln, Castle Rock, CO 80108. The listed phone number is (720) 588-6772.

What is Kelly Nicholson's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Kelly Nicholson enrolled in Medicare?

Yes. Kelly Nicholson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Kelly Nicholson was last updated on August 21, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.