Active NPI
Diane W. Thomas, LMHC
- Mental Health Counselor
- Salem, MA
National Provider Identifier
1073629747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 3717
- Practice address
- 284 Washington St
Salem, MA 01970-3640 - Phone
- (978) 745-0078
- Fax
- (781) 735-0267
- NPI assigned
- Aug 22, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 3717 | MA | Primary |
Addresses
Primary practice location
284 Washington St
Salem, MA 01970-3640
Mailing address
12 Harris St
Marblehead, MA 01945-3427
Phone (781) 704-7253
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Previously, effective Aug 12, 2024 through Aug 12, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3717 | MA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073629747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 HARRIS ST",
"city": "MARBLEHEAD",
"state": "MA",
"postal_code": "019453427",
"telephone_number": "781-704-7253",
"fax_number": "781-735-0267"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "284 WASHINGTON ST",
"city": "SALEM",
"state": "MA",
"postal_code": "019703640",
"telephone_number": "978-745-0078",
"fax_number": "781-735-0267"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "DIANE",
"middle_name": "W.",
"name_prefix": "Ms.",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "3717",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.