Individual provider Active NPI

Laura Beth Zahodne, PH.D.

  • Clinical Psychologist
  • Ann Arbor, MI
National Provider Identifier
1720529308
Registry record updated Mar 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301016995 Issued in MI
Practice address
500 E Washington St
Ann Arbor, MI 48104-2057
Phone
(734) 764-9466
NPI assigned
Mar 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301016995 MI Primary

Addresses

Primary practice location

500 E Washington St
Ann Arbor, MI 48104-2057

Mailing address

530 Church St
Ann Arbor, MI 48109-1043
Phone (734) 764-4098

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301016995MIMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1489536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489536000000",
    "number": "1720529308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 CHURCH ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481091043",
            "telephone_number": "734-764-4098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E WASHINGTON ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481042057",
            "telephone_number": "734-764-9466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAHODNE",
        "first_name": "LAURA",
        "middle_name": "BETH",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-15",
        "last_updated": "2017-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301016995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2017; 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.