Susan Cohn Koller, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

P1176 Issued in TN

Practice address

305 Westfield Dr
Knoxville, TN 37919-4824

Phone

(865) 588-7598

Fax

(865) 588-6406

NPI assigned

May 19, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Susan Cohn Koller Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294099200000",
    "number": "1679527287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 WESTFIELD DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194824",
            "telephone_number": "865-588-7598",
            "fax_number": "865-588-6406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 WESTFIELD DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194824",
            "telephone_number": "865-588-7598",
            "fax_number": "865-588-6406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLER",
        "first_name": "SUSAN",
        "middle_name": "COHN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2011-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "TN",
            "license": "P1176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "KOLLER",
            "middle_name": "COHN",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kallie Kolarik
• Michael T Kolarik, O.D.
• Joyce Jeanine Kolesar
• Mary Fleming Kollar, FNP
• Clayton Kolle, M.D.
• Bonnie Kolnick
• Robert A. Kolock, MD
• Samantha A Kolyer
• Wanda Elisabet Komjathy
• Melanie Kondrat, IBCLC

• Clinical Child & Adolescent Psychologist in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Clinical Child & Adolescent Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2011; 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.