Active NPI
Eileen L Cooley, PH.D.
- Psychologist
- Atlanta, GA
National Provider Identifier
1376675835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1172
- Practice address
- 1780 Century Blvd NE Ste B
Atlanta, GA 30345-3399 - Phone
- (404) 633-0071
- NPI assigned
- Mar 11, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1172 | GA | Primary |
Addresses
Primary practice location
1780 Century Blvd NE Ste B
Atlanta, GA 30345-3399
Mailing address
2486 Williamswood CT
Decatur, GA 30033-2810
Phone (404) 982-0706
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110923000544 | GA | Practitioner - Clinical Psychologist | 1254502172 | Practice locations: Atlanta, GA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1774 -C Century Blvd NE
Atlanta, GA 30345-3399
Phone (404) 633-0071
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1172 | GA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376675835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2486 WILLIAMSWOOD CT",
"city": "DECATUR",
"state": "GA",
"postal_code": "300332810",
"telephone_number": "404-982-0706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1780 CENTURY BLVD NE STE B",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303453399",
"telephone_number": "404-633-0071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOLEY",
"first_name": "EILEEN",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "GA",
"license": "1172",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.