Healthcare Provider Details

I. General information

NPI: 1124668330
Provider Name (Legal Business Name): KERRY MURRAY OHARA PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2020
Last Update Date: 05/21/2025
Certification Date: 01/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

423 GEYSER ROAD
BALLSTON SPA NY
12020
US

IV. Provider business mailing address

386 CAROLINE ST
SARATOGA SPRINGS NY
12866-3739
US

V. Phone/Fax

Practice location:
  • Phone: 518-886-8776
  • Fax: 518-886-3846
Mailing address:
  • Phone: 518-581-1515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number015199-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: