Diane Menke Pence, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

39002125A Issued in IN

Legal business name

DIANE MENKE PENCE, LLC

Practice address

205 N College Ave
Ste 613
Bloomington, IN 47404-3950

Phone

(812) 333-3440

Fax

(812) 333-3444

NPI assigned

Jun 15, 2010

Organization subpart

No

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

Authorized official

Name

Diane Menke Pence, LMHC

Title

Owner

Phone

(812) 876-6322

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Diane Menke Pence, LMHC Other name

Locations

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

{
    "created_epoch": "1276560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276560000000",
    "number": "1023339967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1522 N LIMESTONE DR",
            "city": "ELLETTSVILLE",
            "state": "IN",
            "postal_code": "474299363",
            "telephone_number": "812-876-6322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N COLLEGE AVE",
            "address_2": "STE 613",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474043950",
            "telephone_number": "812-333-3440",
            "fax_number": "812-333-3444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIANE MENKE PENCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-15",
        "last_updated": "2010-06-15",
        "status": "A",
        "authorized_official_last_name": "PENCE",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "MENKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-876-6322",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39002125A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVUDAL",
            "identifier": "158893992",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diane Menke Pence, LMHC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Mental Health Counselor in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2010; 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.