Individual provider Active NPI

Deliz Jivon Byrd, MS

  • Professional Counselor
  • Independence, KS
National Provider Identifier
1598933384
Registry record updated Jan 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2374 Issued in KS
Practice address
3751 W Main St
Independence, KS 67301-8446
Phone
(620) 331-1748
NPI assigned
Feb 14, 2008
Last updated
Jan 9, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 4596 OK
Professional Counselor 101YP2500X 2374 KS Primary

Addresses

Primary practice location

3751 W Main St
Independence, KS 67301-8446

Mailing address

PO Box 688
Independence, KS 67301-0688
Phone (620) 331-1748

Other names 1

  • Deliz Jivon Murry Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240411004430 KS Practitioner - Mental Health Counselor 0143669093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kanza Mental Health and Guidance Center, Inc.Group PAC ID 7810958998, 9 clinicians

Practice addresses (Care Compare)

909 S 2ND St
Hiawatha, KS 66434-2774
Phone (785) 742-7113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2374KSMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kanza Mental Health and Guidance Center, Inc. CurrentSince Mar 2, 2024 Accepting new patients
Pawnee Mental Health Service, Inc. Past Accepting new patients

Locations

909 S 2nd St
Hiawatha, KS 66434
Phone (785) 742-7113

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1202947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420761600000",
    "number": "1598933384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 688",
            "city": "INDEPENDENCE",
            "state": "KS",
            "postal_code": "673010688",
            "telephone_number": "620-331-1748",
            "fax_number": "620-332-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3751 W MAIN ST",
            "city": "INDEPENDENCE",
            "state": "KS",
            "postal_code": "673018446",
            "telephone_number": "620-331-1748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYRD",
        "first_name": "DELIZ",
        "middle_name": "JIVON",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-14",
        "last_updated": "2015-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "4596",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KS",
            "license": "2374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DELIZ",
            "last_name": "MURRY",
            "middle_name": "JIVON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Independence, KS

Sources for this page

Verify at the official NPI Registry.