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General NPI Number Information
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NPI Number | 1427070309
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Entity Type | Individual
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Provider Name | JAMES KOUSOULAS PH.D
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Gender | Male
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 220 E 54TH ST SUITE 1B
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City | NEW YORK
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State | NY
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Zip | 10022-4837
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Country | US
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Telephone | 212-755-7424
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Fax | 212-755-7424
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Provider Business Mailing Address
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Address Line | 178 ELIZABETH ST
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City | PEARL RIVER
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State | NY
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Zip | 10965-3007
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Country | US
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Telephone | 845-735-4681
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Fax | 845-735-4681
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 000287-1
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License Number State | NY
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