Individual provider Active NPI

Angelica Coumanova, PHD

  • Clinical Psychologist
  • Arlington, TX
National Provider Identifier
1235908518
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
39686 Issued in TX
Practice address
3939 W Green Oaks Blvd Ste 206
Arlington, TX 76016-2793
Phone
(682) 305-2123
Fax
(682) 305-2123
NPI assigned
Dec 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 39686 TX Primary

Addresses

Primary practice location

3939 W Green Oaks Blvd Ste 206
Arlington, TX 76016-2793

Mailing address

3939 W Green Oaks Blvd Ste 206
Arlington, TX 76016-2793
Phone (682) 305-2123

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

LicenseStateTypeSpecialty
39686TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Services for Children and Families Clinical PastSince Dec 31, 2023 Accepting new patients

Organizations & group practices 1

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": "1703635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1235908518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3939 W GREEN OAKS BLVD STE 206",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760162793",
            "telephone_number": "682-305-2123",
            "fax_number": "682-305-2123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 W GREEN OAKS BLVD STE 206",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760162793",
            "telephone_number": "682-305-2123",
            "fax_number": "682-305-2123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUMANOVA",
        "first_name": "ANGELICA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-27",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "39686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; 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.