Kevin S. Weatherly, PH.D.
NPI 1164785556ActiveIndividual· Psychologist· Greenville, TX
Psychologist (PH.D.) in Greenville, Texas, licensed in TX, with an NPI issued in June 2012. Enrolled in Medicare as practitioner - clinical psychologist.
Overview
| NPI | 1164785556 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PH.D. |
| Sole proprietor | Yes |
| NPI issued | Jun 20, 2012 |
| Last updated in NPPES | Jul 6, 2023 |
| Certified by provider | Jul 6, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | 37657 | TX |
| Psychologist, Clinical | 103TC0700X | 37657 | TX |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Psychologist (TX) |
|---|
Education and affiliations
| Graduation year | 2014 |
|---|---|
| Medicare specialty | Clinical Psychologist |
| Telehealth | Offers telehealth |
Other Psychologist providers in Greenville
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- 1578512505
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