Active NPI
Edward J. Zdenek, SC.D.
- Cognitive & Behavioral Psychologist
- Holliston, MA
National Provider Identifier
1235113135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cognitive & Behavioral Psychologist
- License
- 2784
- Practice address
- 770 Washington St.
Suite 3
Holliston, MA 01746 - Phone
- (508) 429-7311
- NPI assigned
- Dec 4, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | 2784 | MA | Primary |
Addresses
Primary practice location
770 Washington St.
Suite 3
Holliston, MA 01746
Mailing address
770 Washington St.
Suite 3
Holliston, MA 01746
Phone (508) 429-7311
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2784 | MA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294099200000",
"number": "1235113135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "770 WASHINGTON ST.",
"address_2": "SUITE 3",
"city": "HOLLISTON",
"state": "MA",
"postal_code": "01746",
"telephone_number": "508-429-7311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "770 WASHINGTON ST.",
"address_2": "SUITE 3",
"city": "HOLLISTON",
"state": "MA",
"postal_code": "01746",
"telephone_number": "508-429-7311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZDENEK",
"first_name": "EDWARD",
"middle_name": "J.",
"credential": "SC.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-12-04",
"last_updated": "2011-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "MA",
"license": "2784",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holliston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.