Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Kevin S Weatherly, PHD

Individual provider Clinical Psychologist · NPI 1164785556

Dr. Kevin S Weatherly, PHD is a Clinical Psychologist in Greenville, Texas. Qualified in 2014, 12 years ago. Practices as a sole proprietor, accepts Medicare assignment and offers telehealth. Licensed in Texas.

Years since qualifying
12
Licensed in
TX
In the registry since
2012
Specialties on file
2
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

See every abbreviation used in this directory →

Practice location Address checks out

5604 Wesley St Ste 104
Greenville, TX 75402-6326
Phone: (903) 883-7792
Fax: (903) 488-5303
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence 37657 (TX)
Clinical Psychologist Taxonomy 103TC0700X · Licence 37657 (TX)

Record details

NPI number1164785556
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorYes
NPI enumeratedJune 20, 2012
Last updated in NPPESJuly 6, 2023
Certification dateJuly 6, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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