DR. KAREN M MIKOLIC (NPI# 1952680829) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952680829 |
| Entity Type | Individual |
| Full Name | DR. KAREN M MIKOLIC |
| Credential | PH.D. |
| Practice Address |
3050 Broadway St. Boulder CO 80304-3154 |
| Mailing Address |
Po Box 1364 Boulder CO 80306-1364 |
| Practice Telephone | 7207152212 |
| Practice Fax Number | 3218436836 |
| Mailing Telephone | 7207152212 |
| Mailing Fax Number | 8883148174 |
| Enumeration Date | 2011-08-10 |
| Last Update Date | 2020-03-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | PY8438 | FL | Behavioral Health & Social Service Providers |
| N | 103T00000X | Psychologist | PSY1000723 | DC | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MEDICAL LICENSE | PY8438 | 01 |
| FL | N/A | 05 |
| Street Address |
3050 BROADWAY ST. |
| City | BOULDER |
| State | CO |
| Zip Code | 80304-3154 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407365794 | Piece of Mind Neuropsychology LLC | Clinical Neuropsychologist | 3050 Broadway St., Boulder, CO 80304-3154 | 2017-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720605256 | Evol.v Chiropractic LLC | Chiropractor | 2401 Broadway #208, Boulder, CO 80304 | 2020-07-01 |
| 1760038723 | Patrica Anne Zeyher | Counselor | 100 Alpine Ave., Boulder, CO 80304 | 2019-08-15 |
| 1356855928 | Opal Counseling Center, LLC | Counselor | 1480 Lee Hill Dr. #7, Boulder, CO 80304 | 2017-11-19 |
| 1831608603 | Lesley Ann Cloke | Dietitian, Registered | 1895 Bluff St., Unit C, Boulder, CO 80304 | 2017-09-25 |
| 1790209740 | Megan Litwiller | Occupational Therapist | 810 Maxwell Ave, Boulder, CO 80304 | 2017-08-01 |
| 1285163774 | Nadine Martin | Registered Nurse | 311 Mapleton Ave # 331, Boulder, CO 80304 | 2017-06-08 |
| 1598119281 | Megan Cronin Larson | Social Worker | 825 S. Broadway Street, Boulder, CO 80304 | 2016-04-19 |
| 1760844237 | Rafia Rebeck | Counselor | 1235 Elder Ave #7, Boulder, CO 80304 | 2016-03-24 |
| 1629441688 | Jennifer S Delaney | Counselor | 2334 Broadway, Ste. B, Boulder, CO 80304 | 2015-11-12 |
| 1891162301 | Kingston Dialysis LLC | Clinic/Center | 2880 Folsom St Ste 110, Boulder, CO 80304 | 2015-09-01 |
| Find all providers in zip 80304 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255848321 | Jill Gitten Aloia | Clinical Neuropsychologist | 2501 Walnut St Ste 102, Boulder, CO 80302-5752 | 2018-01-10 |
| 1487192076 | Icn Pllc | Clinical Neuropsychologist | 255 Canyon Blvd Ste 300-f, Boulder, CO 80302-4979 | 2017-02-03 |
| 1720537467 | Zachary Sussman | Clinical Neuropsychologist | 2501 Walnut St Ste 104, Boulder, CO 80302-5752 | 2016-09-22 |
| 1730414657 | Pg Neuropsychology | Clinical Neuropsychologist | 433 Mapleton Ave Apt A, Boulder, CO 80304-3994 | 2009-10-09 |
| 1144340365 | Robert B Mcintyre | Clinical Neuropsychologist | 2305 Canyon Blvd Ste 205, Boulder, CO 80302-5655 | 2007-03-30 |
| 1609923721 | Michele L. Gerard | Clinical Neuropsychologist | 1750 30th St # 224, Boulder, CO 80301-1029 | 2007-01-03 |
| 1326104415 | Bobby Lee Gant | Clinical Neuropsychologist | 255 Canyon Blvd Ste 300f, Boulder, CO 80302 | 2006-12-31 |
| 1316024110 | Emily D. Richardson | Clinical Neuropsychologist | 345 Ucb, Muenzinger D232a, Boulder, CO 80309-0345 | 2006-11-01 |
| 1811079494 | Kathryn Kaye | Clinical Neuropsychologist | 2501 Walnut St Ste 201, Boulder, CO 80302-5753 | 2006-10-20 |
| 1245264571 | Neuropsychological Consultants, L.L.C. | Clinical Neuropsychologist | 1919 14th St Ste 812, Boulder, CO 80302-5310 | 2006-07-11 |
| Find all providers in BOULDER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.