DR. ELLEN CHAZDON PSY D LP
NPI 1205868635
Psychologist in Edina, MN

Active since July 07, 2006Opted out of Medicare · through Oct 5, 2026
5100 EDEN AVE, SUITE 117, EDINA, MN 55436(952) 920-9304(952) 920-9304 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Ellen Chazdon Psy D Lp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ELLEN CHAZDON PSY D LP (NPI 1205868635) is an individual psychologist in Edina, Minnesota, licensed in Minnesota (3170) and active in the NPI registry since July 2006. She has opted out of Medicare through October 5, 2026.

NPPES Registry Identity

NPI1205868635
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. ELLEN CHAZDONCredential: PSY D LP
Location Address5100 EDEN AVE, SUITE 117Edina, MN 55436-2337
Mailing Address5100 Eden Ave, Suite 117Edina, MN 55436-2337 · (952) 920-9304 · Fax (952) 920-9304
Fax(952) 920-9304
Sole ProprietorYes
Enumeration DateJuly 7, 2006
Last NPPES UpdateJuly 8, 2007
NPI 1205868635 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in MN · 3170
Definition
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.
5100 EDEN AVE, Edina, MN 55436

Other Identifiers 5

Other7954181MN · Aetna
Other6178275Ubh
Other76D36BRMN · Bcbs
Other24725MN · Definity
Other108515MN · Ucare

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Dr. Ellen Chazdon Psy D Lp has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 5, 2022 through October 5, 2026.

Opt-Out Effective DateOctober 5, 2022
Opt-Out In Effect ThroughOctober 5, 2026Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist (General Practice)
5100 EDEN AVE, #209
EDINA, MN 55436
Dentist (General Practice)
5100 EDEN AVE
EDINA, MN 55436
Psychologist (Forensic)
5100 EDEN AVE, SUITE 320
EDINA, MN 55436
Social Worker (Clinical)
5100 EDEN AVE, 316
EDINA, MN 55436
Marriage & Family Therapist
5100 EDEN AVE, SUITE 102-A
EDINA, MN 55436
Social Worker (Clinical)
5100 EDEN AVE, SUITE 109
EDINA, MN 55436
Social Worker
5100 EDEN AVE, STE. 108
EDINA, MN 55436
Dentist (Prosthodontics)
5100 EDEN AVE, STE 209
EDINA, MN 55436

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ellen Chazdon's NPI number?

The NPI number for Ellen Chazdon is 1205868635. It was assigned to this individual provider in the NPPES registry on July 7, 2006.

Where is Ellen Chazdon located?

Ellen Chazdon practices at 5100 Eden Ave Suite 117, Edina, MN 55436. The listed phone number is (952) 920-9304.

What is Ellen Chazdon's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Ellen Chazdon enrolled in Medicare?

No. Ellen Chazdon has opted out of Medicare through October 5, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Ellen Chazdon was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.