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

Kelly M Stanek, PHD

Individual provider Clinical Neuropsychologist · NPI 1063862639

Kelly M Stanek, PHD is a Clinical Psychologist in Augusta, Georgia. Qualified in 2011, 15 years ago. Practices with Wellstar Medical Group LLC, a 3,072-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Georgia and Wisconsin.

Years since qualifying
15
Licensed in
GA, WI
In the registry since
2016
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.

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Practice location Address checks out

1120 15th St
Augusta, GA 30912-0004
Phone: (706) 721-4581
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1313 Fish Hatchery Rd, Madison, WI 53715-1911 — (608) 252-8000

Specialties & licences

Clinical Neuropsychologist (primary) Taxonomy 103G00000X · Licence PSY004125 (GA)
Clinical Neuropsychologist Taxonomy 103G00000X · Licence 3375-057 (WI)

Record details

NPI number1063862639
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHD
Sole proprietorNo
NPI enumeratedJune 15, 2016
Last updated in NPPESAugust 4, 2023
Certification dateAugust 4, 2023

Medicare enrollment

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

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Wellstar Medical Group Llc — 3072 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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