Active NPI
Amy Jeanette Mikolajewski, PH.D.
- Clinical Psychologist
- Metairie, LA
National Provider Identifier
1720519135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1419
- Practice address
- 4641 Fairfield St Ste a
Metairie, LA 70006-2763 - Phone
- (504) 875-4587
- NPI assigned
- Mar 27, 2017
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1419 | LA | Primary |
Addresses
Primary practice location
4641 Fairfield St Ste a
Metairie, LA 70006-2763
Mailing address
1440 Canal St
8448
New Orleans, LA 70112-2703
Phone (504) 988-4526
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Administrators of the Tulane Educational Fund | 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.
-
dba Tulane University Medical Group
- Specialist
- New Orleans, LA
- NPI 1528014164
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601424000000",
"number": "1720519135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1440 CANAL ST",
"address_2": "8448",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701122703",
"telephone_number": "504-988-4526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4641 FAIRFIELD ST STE A",
"city": "METAIRIE",
"state": "LA",
"postal_code": "700062763",
"telephone_number": "504-875-4587"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIKOLAJEWSKI",
"first_name": "AMY",
"middle_name": "JEANETTE",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-27",
"last_updated": "2020-09-30",
"certification_date": "2020-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "LA",
"license": "1419",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Metairie, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.