Active NPI
Julene D Nolan, PSY.D.
- School Psychologist
- Mankato, MN
National Provider Identifier
1609200690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 468441
- Practice address
- 12 Civic Center PLZ
Suite 1615
Mankato, MN 56001-7781 - Phone
- (507) 345-4679
- Fax
- (597) 345-8685
- NPI assigned
- Aug 26, 2013
- 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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 468441 | MN | Primary |
Addresses
Primary practice location
12 Civic Center PLZ
Suite 1615
Mankato, MN 56001-7781
Mailing address
12 Civic Center PLZ
Suite 1615
Mankato, MN 56001-7781
Phone (507) 345-4679
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 468441 | MN | MD | School Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Addictions and Stress Clinics LTD | Past | 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.
-
- Psychologist
- Mankato, MN
- NPI 1376820118
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377475200000",
"number": "1609200690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 CIVIC CENTER PLZ",
"address_2": "SUITE 1615",
"city": "MANKATO",
"state": "MN",
"postal_code": "560017781",
"telephone_number": "507-345-4679",
"fax_number": "597-345-8685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 CIVIC CENTER PLZ",
"address_2": "SUITE 1615",
"city": "MANKATO",
"state": "MN",
"postal_code": "560017781",
"telephone_number": "507-345-4679",
"fax_number": "597-345-8685"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOLAN",
"first_name": "JULENE",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-08-26",
"last_updated": "2013-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "MN",
"license": "468441",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mankato, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.