DR. WILLIAM JEFFREY KELLY (PH.D.) – Counselor, NPI 1609842616

DR. WILLIAM JEFFREY KELLY (PH.D.) is a healthcare provider. based in Akron, Ohio. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. 3727 (OH). The NPI Number for DR. WILLIAM JEFFREY KELLY (PH.D.) is 1609842616

Main info

Male
41 Years Of Experience
Accepts Medicare Assignment
Name
DR. WILLIAM JEFFREY KELLY (PH.D.)
NPI
1609842616
Phone
(330) 762-5425
Address
640 W MARKET ST
Enumeration Date
28 February 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3307625425
Graduation Year
1985 (41 years ago)
PAC ID
5698940286
Group Practice PAC ID
6709771843
Professional Enrollment ID
I20111209000312
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,139 CLINICAL PSYCHOLOGIST in OH

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Provider Addresses for DR. WILLIAM JEFFREY KELLY (PH.D.)

  • 640, West Market Street, Hall Park Allotment Historic District, Akron, Summit County, Ohio, 44303, United States

    AKRON, OH 443031413

    Phone: (330) 762-5425

    Fax: (330) 762-4019

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-12-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20111209000312IClinical PsychologistOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 44303)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6709771843View full group profile
NameSpecialtyState
Clinical Social WorkerOH
-OH
Physical Therapist In Private PracticeOH
Clinical Social WorkerOH
-OH
Mental Health CounselorOH
Clinical Social WorkerOH
Gastroenterology, Internal MedicineOH
Clinical Social WorkerOH
Mental Health CounselorOH

Reviews

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Frequently asked questions

Can I cross-check DR. WILLIAM JEFFREY KELLY (PH.D.) using NPI 1609842616?
NPI 1609842616 belongs to DR. WILLIAM JEFFREY KELLY (PH.D.); compare other details if you need extra assurance.
Is there an active status for DR. WILLIAM JEFFREY KELLY (PH.D.)?
For scheduling context, DR. WILLIAM JEFFREY KELLY (PH.D.) is shown as active in the registry.
What area of care is associated with DR. WILLIAM JEFFREY KELLY (PH.D.)?
DR. WILLIAM JEFFREY KELLY (PH.D.)'s record emphasizes Counselor. Clinical services aligned with this taxonomy classification.
What locale is associated with DR. WILLIAM JEFFREY KELLY (PH.D.)?
Directory geography for DR. WILLIAM JEFFREY KELLY (PH.D.) centers on Akron, Ohio.
Does DR. WILLIAM JEFFREY KELLY (PH.D.) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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