Kelly Bauman, PSY.D
NPI 1174802730ActiveIndividual· Psychologist, Clinical· Crystal Lake, IL
Psychologist, Clinical (PSY.D) in Crystal Lake, Illinois, licensed in IL, with an NPI issued in August 2011. Enrolled in Medicare as practitioner - clinical psychologist.
Overview
| NPI | 1174802730 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PSY.D |
| Sole proprietor | Yes |
| NPI issued | Aug 12, 2011 |
| Last updated in NPPES | May 21, 2021 |
| Certified by provider | May 21, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | 071008887 | IL |
| Marriage & Family Therapist | 106H00000X | 166.000207 | IL |
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 (IL) |
|---|
Education and affiliations
| Graduation year | 2011 |
|---|---|
| Medicare specialty | Clinical Psychologist |
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