Destiny Azia Eden

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1722720231 Issued in NY

Practice address

1400 Old Country Rd Ste C103N
Westbury, NY 11590-5156

Phone

(516) 806-6969

NPI assigned

Apr 15, 2024

Last updated

Apr 15, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kidz Psychological Services PLLC

  • Clinical Psychologist
  • Garden City, NY
  • NPI 1487326716
  NPD
• Family of Kidz

  • Specialist
  • Westbury, NY
  • NPI 1760313282
  NPD (past)

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

{
    "created_epoch": "1713139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1427802644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 OLD COUNTRY RD STE C103N",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115905156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 OLD COUNTRY RD STE C103N",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115905156",
            "telephone_number": "516-806-6969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDEN",
        "first_name": "DESTINY",
        "middle_name": "AZIA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-15",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "1722720231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• East Meadow Union Free School District
• Carolyn Marie Eckhoff, MS
• Eda-Mae Minto-Brooks SLP PLLC
• Rebecca Edelman, OTR/L
• Sydney Taylor Edelstein, CF-SLP, TSSLD
• Edward M. Goldberg O.D.
• Alexandria Patrice Edwards, RN, MSN, CPNP-PC
• Glen F Ehrenman, D.D.S.
• Eleni Feldman LMHC LLC
• Laika Elmonus, LPN

• Psychologist in Westbury, NY
• Providers in Westbury, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; 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.