Provider Demographics
NPI:1376569236
Name:NIEMEIER, JANET P (PHD)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:P
Last Name:NIEMEIER
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:PO BOX 55310
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35255-5310
Mailing Address - Country:US
Mailing Address - Phone:205-731-9701
Mailing Address - Fax:
Practice Address - Street 1:1717 6TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1801
Practice Address - Country:US
Practice Address - Phone:205-934-3450
Practice Address - Fax:205-975-9754
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2123103TC0700X, 103TR0400X
NC4461103TC0700X, 103T00000X, 103TR0400X
VA0810001172103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1376569236Medicaid
SCPS0536Medicaid
VA7708921Medicaid
SCPS0536Medicaid
NCQ45171AMedicare PIN
680001488Medicare PIN