1720490717 NPI number — NADIA DELSHAD PSY.D., M.SC.

NPI Number: 1720490717
Health Care Provider/Practitioner: NADIA DELSHAD PSY.D., M.SC.

NPI Number : 1720490717 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1720490717",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DELSHAD",
    "FirstName": "NADIA",
    "MiddleName": null,
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "PSY.D., M.SC.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "82 PALOMINO LN STE 703",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BEDFORD",
    "MailingAddressStateName": "NH",
    "MailingAddressPostalCode": "03110-6448",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "603-552-5664",
    "MailingAddressFaxNumber": "603-552-5664",
    "FirstLinePracticeLocationAddress": "82 PALOMINO LN STE 703",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BEDFORD",
    "PracticeLocationAddressStateName": "NH",
    "PracticeLocationAddressPostalCode": "03110-6448",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "603-552-5664",
    "PracticeLocationAddressFaxNumber": "603-552-5664",
    "EnumerationDate": "05/23/2014",
    "LastUpdateDate": "02/08/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "C3689",
          "LicenseNumberStateCode": "OR",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "2223",
          "LicenseNumberStateCode": "NH",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}