Individual provider Active NPI

Nezhat M. Edalatian, PH.D., LPC

  • Mental Health Counselor
  • Phoenix, AZ
National Provider Identifier
1215037130
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC-2526 Issued in AZ
Practice address
5251 N 16TH St
Suite 707
Phoenix, AZ 85016-3217
Phone
(602) 510-8012
Fax
(480) 317-9867
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC-2526 AZ Primary

Addresses

Primary practice location

5251 N 16TH St
Suite 707
Phoenix, AZ 85016-3217

Mailing address

7601 N 22ND St
Phoenix, AZ 85020-4706
Phone (602) 510-8012

Other names 1

  • Dr. Nezhat M. Edalatian-McCain Other name

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LPC-2526AZMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215037130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7601 N 22ND ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204706",
            "telephone_number": "602-510-8012",
            "fax_number": "480-317-9867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5251 N 16TH ST",
            "address_2": "SUITE 707",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850163217",
            "telephone_number": "602-510-8012",
            "fax_number": "480-317-9867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDALATIAN",
        "first_name": "NEZHAT",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PH.D., LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LPC-2526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NEZHAT",
            "last_name": "EDALATIAN-MCCAIN",
            "middle_name": "M.",
            "prefix": "DR.",
            "credential": "PH.D., LPC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.