MEDICARE: KELSEY ANNE KANGOS PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC1900X	Counseling Psychologist	PS01882	RI
2	103TC1900X	Counseling Psychologist	39448	TX

General Provider Information

NPI Number	:	1710312558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSEY ANNE KANGOS PHD

Provider Business Mailing Address
First Line	:	7421 BURNET RD # 104
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78757-2244
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7421 BURNET RD # 104
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78757-2244
Country	:	US
Telephone Number	:	512-524-7497
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2013
Last Update Date	:	02/13/2026

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Directions to “ KELSEY ANNE KANGOS PHD” Practice Location

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