Individual provider Active NPI

Maria M Diz, LMHC

  • Professional Counselor
  • West Palm Beach, FL
National Provider Identifier
1073918686
Registry record updated Apr 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
MH16824 Issued in FL
Practice address
410 Evernia St Apt 221
West Palm Beach, FL 33401-5433
Phone
(561) 248-4831
NPI assigned
Oct 24, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X MH16824 FL Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

410 Evernia St Apt 221
West Palm Beach, FL 33401-5433

Mailing address

410 Evernia St Apt 221
West Palm Beach, FL 33401-5433
Phone (561) 248-4831

Other practice location 1

1411 N Flagler Dr Ste 9300B
West Palm Beach, FL 33401-3404
Phone (561) 248-4831

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240113000713 FL Practitioner - Mental Health Counselor 4183076201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brightside Health IncGroup PAC ID 9234525098, 213 clinicians

Practice addresses (Care Compare)

Jacksonville, FL 32211
Phone (415) 360-3348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Arts, Master of Arts

State licenses

LicenseStateTypeSpecialty
MH16824FLMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Health, Inc. CurrentSince Jan 10, 2024 Accepting new patients
Creative Care Healing Counseling & Consulting Professional CurrentSince May 3, 2020 Accepting new patients
Brightside Medical, P.C. Past Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

6501 Arlington Expy
Ste B105
Jacksonville, FL 32211
Phone (904) 302-9355

1411 N Flagler Dr
Ste 9300B
West Palm Beach, FL 33401
Phone (561) 248-4831

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588204800000",
    "number": "1073918686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 EVERNIA ST APT 221",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334015433",
            "telephone_number": "561-248-4831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 EVERNIA ST APT 221",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334015433",
            "telephone_number": "561-248-4831"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1411 N Flagler Dr Ste 9300B",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334013404",
            "country_code": "US",
            "telephone_number": "561-248-4831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIZ",
        "first_name": "MARIA",
        "middle_name": "M",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-24",
        "last_updated": "2020-04-30",
        "certification_date": "2020-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "MH16824",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.