Individual provider Active NPI

Dianira Renee Cortez, LPC

  • Mental Health Counselor
  • Meridian, ID
National Provider Identifier
1104523042
Registry record updated Feb 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC-6104 Issued in ID
Practice address
750 W Ustick Rd Ste 120
Meridian, ID 83646-6133
Phone
(208) 991-7378
NPI assigned
Feb 10, 2023
Last updated
Feb 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC-6104 ID Primary

Addresses

Primary practice location

750 W Ustick Rd Ste 120
Meridian, ID 83646-6133

Mailing address

6259 W Black Butte St
Meridian, ID 83646-8704
Phone (208) 991-7873

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPC-6104IDMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1675987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675987200000",
    "number": "1104523042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6259 W BLACK BUTTE ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836468704",
            "telephone_number": "208-991-7873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 W USTICK RD STE 120",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836466133",
            "telephone_number": "208-991-7378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORTEZ",
        "first_name": "DIANIRA",
        "middle_name": "RENEE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-10",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LPC-6104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2023; 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.