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NPISignal

Individual Healthcare Provider

Kelly Ann Pettit, PSYD

NPI Record: ActivePsychologist — Clinical
NPI1194999409
Mchenry, Illinois

Provider's NPPES record last updated: May 29, 2023

Overview

Entity Type
Individual Healthcare Provider
NPI
1194999409
Primary Specialty
Psychologist — Clinical
Practice Location
Mchenry, Illinois
Sole Proprietor
No

Federal Screening

NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.

List of Excluded Individuals/Entities (LEIE)

HHS Office of Inspector General

No potential match identified

No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.

Source data
September 10, 2026
Records indexed
84,001
Screened
Sep 21, 2026, 1:00 AM UTC

This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.

SAM.gov Exclusions

U.S. General Services Administration

Not checked

SAM.gov Exclusions was not checked.

SAM.gov screening is not configured on this deployment. No SAM check has been performed.

Screened
Not checked

This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.

This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.

Run a name-based screening

Searches OIG LEIE and SAM.gov by name and reviews every potential match.

Specialties & Taxonomies

  • Psychologist

    Clinical

    Behavioral Health & Social Service Providers

    Primary

    A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

    Taxonomy code 103TC0700X
  • Psychologist

    Behavioral Health & Social Service Providers

    A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

    Taxonomy code 103T00000X

Provider-Reported License Information

Psychologist (Iowa)
117693
Psychologist (Indiana)
20042375A
Psychologist (Illinois)
071007917
License numbers are reported by the provider to NPPES and are not independently verified by NPISignal against any state licensing board. Confirm current license status directly with the issuing state board.

Practice Locations

Practice Location

659 Ridgeview Dr

Mchenry, Illinois 60050-7012

Phone: (815) 344-1999

Additional Practice Location

3701 Doty Rd

Woodstock, Illinois 60098-7509

Phone: (815) 338-6600

Fax: (815) 206-5376

Additional Practice Location

4201 W Medical Center Dr

Mchenry, Illinois 60050-8409

Phone: (815) 338-6600

Fax: (815) 206-5376

Additional Practice Location

10400 Haligus Rd

Huntley, Illinois 60142-9553

Phone: (815) 338-6600

Fax: (815) 206-5376

Additional Practice Location

750 E Terra Cotta Ave Ste A

Crystal Lake, Illinois 60014-3621

Phone: (815) 344-1999

Fax: (815) 516-5171

Record Information

Enumeration Date
April 17, 2008
Provider's NPPES Record Last Updated
May 29, 2023
Certification Date
May 29, 2023
NPISignal NPPES Dataset
August 2026

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