LYDIA CM BOONZAAYER – Counselor, NPI 1356050850

LYDIA CM BOONZAAYER is a healthcare provider. based in Kalamazoo, Michigan. specializing in MENTAL HEALTH COUNSELOR. They hold a License No. 6451022584 (MI). The NPI Number for LYDIA CM BOONZAAYER is 1356050850

Main info

Female
Sole Proprietor
4 Years Of Experience
Accepts Medicare Assignment
Name
LYDIA CM BOONZAAYER
NPI
1356050850
Phone
(213) 807-0882
Address
3667 S 9TH ST
Enumeration Date
23 November 2022
Last Update Date
23 November 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2693450909
Graduation Year
2022 (4 years ago)
PAC ID
7517489917
Group Practice PAC ID
2961446273
Professional Enrollment ID
I20250314001159
Address ID
MI490081630KA2019XRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

2,023 MENTAL HEALTH COUNSELOR in MI

Provider Addresses for LYDIA CM BOONZAAYER

  • 3667 S 9TH ST

    KALAMAZOO, MI 490099502

    Phone: (213) 807-0882

    Type: Mailing

  • 2019 RAMBLING RD

    KALAMAZOO, MI 490081630

    Phone: (213) 807-0882

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-03-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250314001159IMental Health CounselorMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49009)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2961446273View full group profile
NameSpecialtyState
Clinical Social WorkerMI
Clinical Social WorkerMI
Mental Health CounselorMI
Clinical Social WorkerWI
Clinical Social WorkerMI
Clinical Social WorkerMI
Clinical Social WorkerMI
-MI
Mental Health CounselorMI
Mental Health CounselorMI

Reviews

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Frequently asked questions

What federal number belongs to LYDIA CM BOONZAAYER?
The federal identifier for LYDIA CM BOONZAAYER is NPI 1356050850.
Is LYDIA CM BOONZAAYER active in the national directory?
LYDIA CM BOONZAAYER's public NPI profile is in an active state.
What field does LYDIA CM BOONZAAYER work in?
You can think of LYDIA CM BOONZAAYER as practicing within Counselor. Clinical services aligned with this taxonomy classification.
Does LYDIA CM BOONZAAYER practice in Michigan?
You will see Kalamazoo, Michigan on file for LYDIA CM BOONZAAYER alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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