Active NPI
Ewa Halina Paziak, PSY.D.
- Clinical Psychologist
- Martinez, GA
National Provider Identifier
1306185327
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY003772
- Practice address
- 522 Blackburn Dr
Martinez, GA 30907-8202 - Phone
- (706) 364-1820
- Fax
- (706) 364-1870
- NPI assigned
- Feb 12, 2013
- Last updated
- Feb 6, 2018
- 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 | PSY003772 | GA | Primary |
Addresses
Primary practice location
522 Blackburn Dr
Martinez, GA 30907-8202
Mailing address
522 Blackburn Dr
Martinez, GA 30907-8202
Phone (706) 364-1820
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Apr 1, 2018 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY003772 | GA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517875200000",
"number": "1306185327",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "522 BLACKBURN DR",
"city": "MARTINEZ",
"state": "GA",
"postal_code": "309078202",
"telephone_number": "706-364-1820",
"fax_number": "706-364-1870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "522 BLACKBURN DR",
"city": "MARTINEZ",
"state": "GA",
"postal_code": "309078202",
"telephone_number": "706-364-1820",
"fax_number": "706-364-1870"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAZIAK",
"first_name": "EWA",
"middle_name": "HALINA",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-02-12",
"last_updated": "2018-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "GA",
"license": "PSY003772",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Martinez, GA
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- Susan M Pencille, P.T.
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.