Individual provider Active NPI

Robert Joseph Nolan, PH.D.

  • Clinical Neuropsychologist
  • Dothan, AL
National Provider Identifier
1225138720
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
283 Issued in AL
Practice address
100 Westside Dr
Dothan, AL 36303-1908
Phone
(334) 793-2237
Fax
(334) 712-6256
NPI assigned
Sep 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 283 AL Primary
Adult Development & Aging Psychologist 103TA0700X 283 AL
Cognitive & Behavioral Psychologist 103TB0200X 283 AL
Clinical Psychologist 103TC0700X 283 AL
Counseling Psychologist 103TC1900X 283 AL
Clinical Child & Adolescent Psychologist 103TC2200X 283 AL
Psychologist 103T00000X 283 AL
Family Psychologist 103TF0000X 283 AL
Health Service Psychologist 103TH0100X 283 AL
Rehabilitation Psychologist 103TR0400X 283 AL
School Psychologist 103TS0200X 283 AL

Addresses

Primary practice location

100 Westside Dr
Dothan, AL 36303-1908

Mailing address

100 Westside Dr
Dothan, AL 36303-1908
Phone (334) 793-2237

Other identifiers 1

IdentifierTypeStateIssuer
51071169OtherALBCBS

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
283ALMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Chrysalis, a Home for Girls, Inc. Past Accepting new patients
Milestones Psychology and Therapy Inc Psychologist PastSince Feb 20, 2013 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1225138720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WESTSIDE DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363031908",
            "telephone_number": "334-793-2237",
            "fax_number": "334-712-6256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WESTSIDE DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363031908",
            "telephone_number": "334-793-2237",
            "fax_number": "334-712-6256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLAN",
        "first_name": "ROBERT",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-24",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "AL",
            "license": "283",
            "primary": true
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "AL",
            "license": "283",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "AL",
            "license": "283",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "283",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "AL",
            "license": "283",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "AL",
            "license": "283",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AL",
            "license": "283",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "AL",
            "license": "283",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "AL",
            "license": "283",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "AL",
            "license": "283",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "AL",
            "license": "283",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51071169",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.