Individual provider Active NPI

Diane S. Ack-Mitchell

  • Mental Health Counselor
  • Torrington, CT
National Provider Identifier
1114674512
Registry record updated Mar 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
5358 Issued in CT
Practice address
30 Peck Rd Ste 2105
Torrington, CT 06790-6123
Phone
(860) 361-6204
NPI assigned
Mar 4, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2022

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 5358 CT Primary

Addresses

Primary practice location

30 Peck Rd Ste 2105
Torrington, CT 06790-6123

Mailing address

22 Uxbridge Dr
Robbinsville, NJ 08691-4016
Phone (609) 413-6339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20240321002707 CT Practitioner - Mental Health Counselor 0446697700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
May accept Medicare assignment
Group practices
Challenging Minds LLCGroup PAC ID 9830429794, 7 clinicians

Practice addresses (Care Compare)

30 Peck Rd
Suite 1202
Torrington, CT 06790-6123
Phone (860) 361-6204

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Challenging Minds LLC CurrentSince Mar 12, 2024 Accepting new patients

Locations

30 Peck Rd
Ste 2105
Torrington, CT 06790
Phone (860) 361-6204

30 Peck Rd
Ste 1202
Torrington, CT 06790
Phone (860) 294-4481

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1646352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646352000000",
    "number": "1114674512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 UXBRIDGE DR",
            "city": "ROBBINSVILLE",
            "state": "NJ",
            "postal_code": "086914016",
            "telephone_number": "609-413-6339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PECK RD STE 2105",
            "city": "TORRINGTON",
            "state": "CT",
            "postal_code": "067906123",
            "telephone_number": "860-361-6204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACK-MITCHELL",
        "first_name": "DIANE",
        "middle_name": "S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-04",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "5358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrington, CT

Sources for this page

Verify at the official NPI Registry.