Individual provider Active NPI

Marzena Dagmara Zajda, LCPC

  • Mental Health Counselor
  • Boise, ID
National Provider Identifier
1730476912
Registry record updated Jul 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LCPC-3909 Issued in ID
Practice address
6550 W Emerald St
#108
Boise, ID 83704-8780
Phone
(208) 342-6300
Fax
(208) 342-6301
NPI assigned
Jul 7, 2011
Last updated
Jul 7, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LCPC-3909 ID Primary

Addresses

Primary practice location

6550 W Emerald St
#108
Boise, ID 83704-8780

Mailing address

6550 W Emerald St
#108
Boise, ID 83704-8780
Phone (208) 342-6300

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

State licenses

LicenseStateTypeSpecialty
LCPC-3909IDMDMental Health Counselor

Organizations & group practices 1

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": "1309996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309996800000",
    "number": "1730476912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6550 W EMERALD ST",
            "address_2": "#108",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048780",
            "telephone_number": "208-342-6300",
            "fax_number": "208-342-6301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6550 W EMERALD ST",
            "address_2": "#108",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048780",
            "telephone_number": "208-342-6300",
            "fax_number": "208-342-6301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAJDA",
        "first_name": "MARZENA",
        "middle_name": "DAGMARA",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-07",
        "last_updated": "2011-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC-3909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2011; 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.