Provider Demographics
NPI:1427263888
Name:KOGELSCHATZ, JOAN LEE (PHD)
Entity type:Individual
Prefix:DR
First Name:JOAN
Middle Name:LEE
Last Name:KOGELSCHATZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 HONEYSUCKLE RD
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36305-1934
Mailing Address - Country:US
Mailing Address - Phone:334-794-0719
Mailing Address - Fax:334-671-4547
Practice Address - Street 1:921 HONEYSUCKLE RD
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-1934
Practice Address - Country:US
Practice Address - Phone:334-794-0719
Practice Address - Fax:334-671-4547
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL143101YP2500X
FLPY3209103T00000X
AL0647C104100000X
ALL33106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1886OtherAMERICAN BEHAVIORAL
AL3001795OtherCERIDIAN
AL602389KOGOtherUNITED HEALTHCARE
AL17982OtherBEHAVIORAL HEALTH SYSTEMS
AL511/01620OtherMHCA
ALPOO397561OtherUNITED BEHAVIORAL HEALTH
AL103651OtherTRICARE
AL4381654OtherAETNA
AL81870OtherCIGNA
AL111860OtherCOMPSYCH
AL120776000OtherMAGELLAN
AL51041883OtherBC
AL1886OtherAMERICAN BEHAVIORAL
AL120776000OtherMAGELLAN