NPIMap

Organization Active NPI

Diamond State Therapy

  • Community/Behavioral Health Agency
  • Wilmington, DE
National Provider Identifier
1043882269
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
DIAMOND STATE THERAPY
Practice address
4023 Kennett Pike Ste 275
Wilmington, DE 19807-2018
Phone
(267) 736-0182
NPI assigned
Jul 15, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Authorized official

Name
Carolyn T. Fox, LPCNPI 1396218269
Title
Ceo
Phone
(302) 213-9445

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

4023 Kennett Pike Ste 275
Wilmington, DE 19807-2018

Mailing address

4023 Kennett Pike Ste 275
Wilmington, DE 19807-2018
Phone (267) 736-0182

National Provider Directory

National Provider Directory

Locations

4023 Kennett Pike
Wilmington, DE 19807
Phone (484) 577-9928

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1626307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704326400000",
    "number": "1043882269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4023 KENNETT PIKE STE 275",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198072018",
            "telephone_number": "267-736-0182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4023 KENNETT PIKE STE 275",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198072018",
            "telephone_number": "267-736-0182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAMOND STATE THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-15",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "302-213-9445",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; 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.