Active NPI
Lisa Yazdani, PH.D.
- Clinical Psychologist
- Byram, MS
National Provider Identifier
1285715755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 33539
- Practice address
- 2108 Crossbridge Blvd
Byram, MS 39272-8716 - Phone
- (601) 372-5374
- Fax
- (607) 372-7582
- NPI assigned
- Oct 18, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 33539 | MS | Primary |
Addresses
Primary practice location
2108 Crossbridge Blvd
Byram, MS 39272-8716
Mailing address
2108 Crossbridge Blvd
Byram, MS 39272-8716
Phone (601) 372-5374
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33539 | MS | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285715755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2108 CROSSBRIDGE BLVD",
"city": "BYRAM",
"state": "MS",
"postal_code": "392728716",
"telephone_number": "601-372-5374",
"fax_number": "607-372-7582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2108 CROSSBRIDGE BLVD",
"city": "BYRAM",
"state": "MS",
"postal_code": "392728716",
"telephone_number": "601-372-5374",
"fax_number": "607-372-7582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YAZDANI",
"first_name": "LISA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MS",
"license": "33539",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Byram, MS
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.