1. Home
  2. Directory
  3. New York
  4. Lake Grove
  5. Psychologist
  6. NPI Profile

DR. KELLY COULEHAN CROTTY PHD
NPI 1548829880
Psychologist - Clinical in Lake Grove, NY

Active since June 11, 2019PECOS Enrolled
4 SMITH HAVEN MALL STE 107, LAKE GROVE, NY 11755(646) 580-5107 Get Directions Write a Review

NPPES record last updated: December 18, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 18, 2025, Jun 11, 2019 (2 updates tracked since 2019).

About Dr. Kelly Coulehan Crotty Phd NPPES

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

DR. KELLY COULEHAN CROTTY PHD (NPI 1548829880) is an individual clinical provider in Lake Grove, New York, licensed in New York (022496-1) and active in the NPI registry since June 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1548829880
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. KELLY COULEHAN CROTTYCredential: PHD
Location Address4 SMITH HAVEN MALL STE 107Lake Grove, NY 11755-1219
Mailing Address4 Smith Haven Mall Ste 107Lake Grove, NY 11755-1219 · (646) 580-5107
Phone(646) 580-5107
Sole ProprietorNo
Enumeration DateJune 11, 2019
Last NPPES UpdateDecember 18, 20252 updates tracked since enumeration
NPPES CertifiedDecember 18, 2025
✔ NPI 1548829880 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in NY · 022496-1
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.
4 SMITH HAVEN MALL STE 107, Lake Grove, NY 11755
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kelly Coulehan Crotty Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11755 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
$203.53 typical visit price
range $67.40 – $203.53
Typical copayment $50.88 (range $16.85 – $50.88)
Most-billed visit code 99205
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
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.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ELTONNELLE JAMES
Clinical Neuropsychologist
4 SMITH HAVEN MALL STE 107
LAKE GROVE, NY 11755
Suffolk County (631) 444-8053
FAWAD HASSAN VIQAR PHD
Clinical Neuropsychologist
4 SMITH HAVEN MALL STE 107
LAKE GROVE, NY 11755
Suffolk County (631) 444-8053

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 Coulehan Crotty's NPI number?

The NPI number for Kelly Coulehan Crotty is 1548829880. It was assigned to this individual provider in the NPPES registry on June 11, 2019.

Where is Kelly Coulehan Crotty located?

Kelly Coulehan Crotty practices at 4 Smith Haven Mall Ste 107, Lake Grove, NY 11755. The listed phone number is (646) 580-5107.

What is Kelly Coulehan Crotty's specialty?

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

Is Kelly Coulehan Crotty enrolled in Medicare?

Yes. Kelly Coulehan Crotty is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kelly Coulehan Crotty was last updated on December 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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.