1. Home
  2. Directory
  3. Idaho
  4. Boise
  5. Psychologist
  6. NPI Profile

DR. KELLY PETRINO PSY.D
NPI 1861784068
Psychologist - Clinical in Boise, ID

Active since May 05, 2011
3350 W AMERICANA TER STE 210, BOISE, ID 83706(406) 880-5568 Get Directions Write a Review

NPPES record last updated: May 11, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 11, 2022, Mar 17, 2018, Dec 29, 2017 (3 updates tracked since 2017).

About Dr. Kelly Petrino Psy.d NPPES

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

DR. KELLY PETRINO PSY.D (NPI 1861784068) is an individual clinical provider in Boise, Idaho, licensed in Idaho (203518) and active in the NPI registry since May 2011. She maintains a secondary practice location in Missoula.

NPPES Registry Identity

NPI1861784068
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. KELLY PETRINOCredential: PSY.D
Location Address3350 W AMERICANA TER STE 210Boise, ID 83706-2546
Mailing Address3883 S Como AveMeridian, ID 83642-1446 · (406) 880-5568
Phone(406) 880-5568
Sole ProprietorNo
Enumeration DateMay 5, 2011
Last NPPES UpdateMay 11, 20223 updates tracked since enumeration
NPPES CertifiedMay 11, 2022
✔ NPI 1861784068 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in ID · 203518
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.
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 18071 (MT)
Also ListedPsychologistTaxonomy 103T00000X · License 505 (WY)
3350 W AMERICANA TER STE 210, Boise, ID 83706
Open in Google Maps ↗

Secondary Practice Location 1

Location 1334 E Broadway StMissoula, MT 59802-4618 · Phone (406) 880-5568

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 Petrino's NPI number?

The NPI number for Kelly Petrino is 1861784068. It was assigned to this individual provider in the NPPES registry on May 5, 2011.

Where is Kelly Petrino located?

Kelly Petrino practices at 3350 W Americana Ter Ste 210, Boise, ID 83706. The listed phone number is (406) 880-5568.

What is Kelly Petrino's specialty?

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

When was this NPI record last updated?

The NPPES record for Kelly Petrino was last updated on May 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.