Active NPI
Delyn Kazdan, MSED
- Mental Health Counselor
- Bloomington, IN
National Provider Identifier
1003281114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 1117 N Jackson St
Bloomington, IN 47404-3385 - Phone
- (812) 727-4181
- NPI assigned
- Dec 1, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
1117 N Jackson St
Bloomington, IN 47404-3385
Mailing address
1117 N Jackson St
Bloomington, IN 47404-3385
Phone (812) 727-4181
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39003257A | Other | IN | LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1448928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562889600000",
"number": "1003281114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1117 N JACKSON ST",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474043385",
"telephone_number": "812-727-4181"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1117 N JACKSON ST",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474043385",
"telephone_number": "812-727-4181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAZDAN",
"first_name": "DELYN",
"name_prefix": "Ms.",
"credential": "MSED",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-12-01",
"last_updated": "2019-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "39003257A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.