Individual provider Active NPI

Tania Koolik, PH.D.

  • Psychologist
  • Delray Beach, FL
National Provider Identifier
1871813667
Registry record updated May 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY5478 Issued in FL
Practice address
16244 S Military TRL
Suite 460
Delray Beach, FL 33484-6534
Phone
(561) 883-5959
NPI assigned
Jun 3, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY5478 FL Primary

Addresses

Primary practice location

16244 S Military TRL
Suite 460
Delray Beach, FL 33484-6534

Mailing address

7900 Glades Rd
Suite 320
Boca Raton, FL 33434-4167
Phone (561) 883-5959

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101022001201 FL Practitioner - Clinical Psychologist 3779776612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Lake Worth Beach, FL 33460
Phone (561) 883-5959

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY5478FLMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Tania Koolik, PHD, PA Psychologist CurrentSince May 15, 2012 Accepting new patients
Mauro Reynolds & Associates in Counseling Inc Past Accepting new patients
Cme Psychology Consultants PA PastSince Jan 2, 2012 Accepting new patients

Locations

7900 Glades Rd
Ste 320
Boca Raton, FL 33434

16244 S Military Trl
Ste 460
Delray Beach, FL 33484
Phone (561) 498-5300

512 Lake Ave
Lake Worth Beach, FL 33460
Phone (561) 883-5959

Organizations & group practices 3

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": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336694400000",
    "number": "1871813667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7900 GLADES RD",
            "address_2": "SUITE 320",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334344167",
            "telephone_number": "561-883-5959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16244 S MILITARY TRL",
            "address_2": "SUITE 460",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334846534",
            "telephone_number": "561-883-5959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOLIK",
        "first_name": "TANIA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-03",
        "last_updated": "2012-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY5478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

Verify at the official NPI Registry.