Anastasia Koukoulis, MA.T

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

3359 Cheverly CT
Abingdon, MD 21009-2854

Phone

(727) 366-0323

NPI assigned

Jun 11, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1144889338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3359 CHEVERLY COURT",
            "city": "ABINGDON",
            "state": "MD",
            "postal_code": "21009",
            "telephone_number": "727-366-0323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3359 CHEVERLY CT",
            "city": "ABINGDON",
            "state": "MD",
            "postal_code": "210092854",
            "telephone_number": "727-366-0323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUKOULIS",
        "first_name": "ANASTASIA",
        "credential": "MA.T",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-11",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saran Khalid-Giddings, RDN
• Badia Khalid-Manning, LC12181
• Kiersten Elizabeth Kilczewski, PT, DPT, CLT-LANA
• Karen Elizabeth Kleeman-Jones, LCSW-C
• Stanley M Kman, D.O.
• Jennifer Lee Kurman, P.A.
• Sheryll Dawn Kutcher
• Lakshmi P Baddela, M.D.,P.C.
• Jacquelin Landsman, MPT
• Larada Counseling Services, LLC

• Behavior Analyst in Abingdon, MD
• Providers in Abingdon, MD by specialty
• Behavior Analyst in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.