DR. ANDREW MARK ZAITSOFF (NPI# 1679070924) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679070924 |
| Entity Type | Individual |
| Full Name | DR. ANDREW MARK ZAITSOFF |
| Credential | PH.D. |
| Practice Address |
601 Stadium Mall Dr West Lafayette IN 47907-2052 |
| Practice Telephone | 7654946995 |
| Mailing Telephone | 7654946995 |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2018-04-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 20043139A | IN | Behavioral Health & Social Service Providers |
| Street Address |
601 STADIUM MALL DR |
| City | WEST LAFAYETTE |
| State | IN |
| Zip Code | 47907-2052 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134116767 | Leslie D Lester | Nurse Practitioner | 601 Stadium Mall Dr, West Lafayette, IN 47907-2052 | 2005-09-29 |
| 1730724295 | Brittany Lynn Perry | Registered Nurse | 601 Stadium Mall Dr, West Lafayette, IN 47907-2052 | 2019-11-08 |
| 1477058642 | Karen Elaine Westfall Collier | Counselor | 601 Stadium Mall Dr, West Lafayette, IN 47907-2052 | 2018-03-28 |
| 1689172702 | Zhen Li | Psychologist | 601 Stadium Mall Dr, West Lafayette, IN 47907-2052 | 2018-01-23 |
| 1720586936 | Laura Lee Wagner | Counselor | 601 Stadium Mall Dr, West Lafayette, IN 47907-2052 | 2018-01-23 |
| 1831625672 | Jacqueline Brown | Nurse Practitioner | 601 Stadium Mall Dr, West Lafayette, IN 47907-2052 | 2017-05-11 |
| 1114309655 | Yun Cai | Nurse Practitioner | 601 Stadium Mall Dr, West Lafayette, IN 47907-2052 | 2015-06-21 |
| 1487055422 | Luis Javier Balcazar Jr. | Social Worker | 601 Stadium Mall Dr, West Lafayette, IN 47907-2052 | 2014-09-09 |
| 1497182935 | Susan Lynn Prieto-welch | Psychologist | 601 Stadium Mall Dr, West Lafayette, IN 47907-2052 | 2013-09-30 |
| 1982031530 | Megan Burton | Social Worker | 601 Stadium Mall Dr, West Lafayette, IN 47907-2052 | 2013-09-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285274464 | Christine Michelle Jones | Nurse Practitioner | Lyles-porter Hall 715 Clinic Drive, West Lafayette, IN 47907 | 2020-01-15 |
| 1013415033 | Brianna Johnson | Psychologist | 601 Stadium Mall Drive, Purdue University Student Health Center, 2nd Floor, West Lafayette, IN 47907 | 2018-01-24 |
| 1285095885 | Christina Ellen Manfred | Nurse Practitioner | 601 W. Stadium Ave, West Lafayette, IN 47907 | 2016-03-10 |
| 1265612626 | Anu Subramanian | Speech-Language Pathologist | 500 Oval Drive Purdue University, Dept of Speech Language and Hearing Sciences, West Lafayette, IN 47907 | 2007-11-13 |
| 1720163348 | Andrea Lynn Lopez | Specialist/Technologist | 900 N. University Ave, Room B63, West Lafayette, IN 47907 | 2006-10-25 |
| 1912914680 | Jeanette Stone Leonard | Audiologist | 715 Clinic Drive, Purdue University, West Lafayette, IN 47907 | 2006-08-02 |
| 1447224977 | Lindsey Ann Watson | Specialist/Technologist | 900 N University Dr, Mackey Arena, Room B60, West Lafayette, IN 47907 | 2006-02-13 |
| 1992280960 | Carol Callahan Lancaster | Nurse Practitioner | 601 Stadium Mall Drive, West Lafayette, IN 47907 | 2018-09-26 |
| 1104314046 | Lukas Micheal Passalacqua | Specialist/Technologist | 900 N John R Wooden Dr, West Lafayette, IN 47907 | 2018-04-26 |
| 1053712570 | Purdue Sports Medicine Wl | Internal Medicine | 900 John R Wooden Drive, Mackey Arena, West Lafayette, IN 47907 | 2014-09-16 |
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| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427577485 | Kyle Steven Kittleson | Psychologist | 601 Stadium Mall Dr Fl 2, West Lafayette, IN 47907-2052 | 2017-09-11 |
| 1417384504 | Colleen Maguire Jackson | Psychologist | 703 3rd St, West Lafayette, IN 47907-2081 | 2013-10-03 |
| 1427485655 | Mona Bapat | Psychologist | 148 Sagamore Pkwy W, West Lafayette, IN 47906-1569 | 2013-10-02 |
| 1114354529 | Rebecca L Wong | Psychologist | 703 3rd St, Room 1120, West Lafayette, IN 47907-2081 | 2013-09-30 |
| 1528030681 | Donald L Werden | Psychologist | 601 Stadium Mall Dr, West Lafayette, IN 47907-2052 | 2006-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689273849 | Anahli Mayank Patel | Psychologist | 550 University Blvd Ste 1602, Indianapolis, IN 46202-5149 | 2020-10-20 |
| 1861006587 | Dr Michael Jones Psychological Associates, LLC | Psychologist | 8510 Evergreen Ave Ste 106, Indianapolis, IN 46240-2338 | 2020-09-01 |
| 1477171122 | Ellen Vaughan | Psychologist | 201 N Rose Ave Rm 4054, Bloomington, IN 47405-1005 | 2020-07-09 |
| 1881222016 | Ericka Swanson Psyd Inc. | Psychologist | 9305 Calumet Ave Ste A2, Munster, IN 46321-2888 | 2020-04-01 |
| 1184251316 | Pei-yi Lin | Psychologist | 9504 Rachel Dr, Yorktown, IN 47396-9826 | 2020-03-26 |
| 1679109383 | Christina Chico | Psychologist | 1 Park Row St, Michigan City, IN 46360-6597 | 2020-03-14 |
| 1457998007 | Ne Psychological LLC | Psychologist | 6343 Constitution Dr, Fort Wayne, IN 46804-1547 | 2019-12-03 |
| 1124674908 | Indianapolis Neurobehavioral Health Center LLC | Psychologist | 921 E. 86th St., Suite 210 C, Indianapolis, IN 46240 | 2019-08-16 |
| 1295205615 | Monumental Behavioral Health Inc | Psychologist | 1201 N Post Rd Ste C, Indianapolis, IN 46219-4246 | 2018-11-28 |
| 1528536083 | Rebecca Martinez Reid | Psychologist | 2201 E Woodstock Pl, Bloomington, IN 47401-6180 | 2018-11-02 |
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| City | WEST LAFAYETTE |
| Zip Code | 47907 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.