Individual provider Active NPI

Iwona Szukielojc-Kizziah, B.S

  • Mental Health Counselor
  • Boca Raton, FL
National Provider Identifier
1043765308
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
17651 Issued in FL
Practice address
7100 Camino Real Ste 404
Boca Raton, FL 33433-5510
Phone
(954) 634-2344
NPI assigned
Aug 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X
Mental Health Counselor 101YM0800X 17651 FL Primary

Addresses

Primary practice location

7100 Camino Real Ste 404
Boca Raton, FL 33433-5510

Mailing address

6344 Hatteras Club Dr
Lake Worth, FL 33463-6541
Phone (305) 401-9260

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
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
17651FLMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1471305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1043765308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6344 HATTERAS CLUB DR",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334636541",
            "telephone_number": "305-401-9260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 CAMINO REAL STE 404",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334335510",
            "telephone_number": "954-634-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SZUKIELOJC-KIZZIAH",
        "first_name": "IWONA",
        "credential": "B.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-16",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "17651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.