Individual provider Active NPI

Laura Jean Kassymova, M.A.

  • School Psychologist
  • Phoenix, AZ
National Provider Identifier
1740468883
Registry record updated Feb 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
Practice address
1110 E Missouri Ave
Suite 160
Phoenix, AZ 85014-2707
Phone
(602) 274-1311
Fax
(602) 889-0900
NPI assigned
Jan 31, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X AZ Primary

Addresses

Primary practice location

1110 E Missouri Ave
Suite 160
Phoenix, AZ 85014-2707

Mailing address

1110 E. Missouri Ave
Suite 160
Phoenix, AZ 85014-2751
Phone (602) 274-1311

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
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202688000000",
    "number": "1740468883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 E. MISSOURI AVE",
            "address_2": "SUITE 160",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142751",
            "telephone_number": "602-274-1311",
            "fax_number": "602-889-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 E MISSOURI AVE",
            "address_2": "SUITE 160",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142707",
            "telephone_number": "602-274-1311",
            "fax_number": "602-889-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASSYMOVA",
        "first_name": "LAURA",
        "middle_name": "JEAN",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-31",
        "last_updated": "2008-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; 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.