Active NPI
Joanna T Koulianos, PH.D.
- Clinical Psychologist
- Mobile, AL
National Provider Identifier
1013193010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1453
- Practice address
- 22 N Florida St
Mobile, AL 36607-3108 - Phone
- (251) 654-2429
- Fax
- (251) 470-0409
- NPI assigned
- Jan 21, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1453 | AL | Primary |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 1453 | AL | |
| Clinical Neuropsychologist | 103G00000X | 1453 | AL |
Addresses
Primary practice location
22 N Florida St
Mobile, AL 36607-3108
Mailing address
1956 S University Blvd Ste J
PMB 196
Mobile, AL 36609-2928
Phone (251) 654-2429
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1453 | AL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378339200000",
"number": "1013193010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1956 S UNIVERSITY BLVD STE J",
"address_2": "PMB 196",
"city": "MOBILE",
"state": "AL",
"postal_code": "366092928",
"telephone_number": "251-654-2429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 N FLORIDA ST",
"city": "MOBILE",
"state": "AL",
"postal_code": "366073108",
"telephone_number": "251-654-2429",
"fax_number": "251-470-0409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOULIANOS",
"first_name": "JOANNA",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-21",
"last_updated": "2013-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AL",
"license": "1453",
"primary": true
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "AL",
"license": "1453",
"primary": false
},
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "AL",
"license": "1453",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mobile, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.