Individual provider Active NPI

Diane M. Wilson, M.ED.

  • Mental Health Counselor
  • Gardner, MA
National Provider Identifier
1184141632
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
205 School St. #202
Gardner, MA 01440
Phone
(978) 630-4918
Fax
(978) 630-3049
NPI assigned
Aug 25, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 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 MA Primary

Addresses

Primary practice location

205 School St. #202
Gardner, MA 01440

Mailing address

205 School St Ste 202
Gardner, MA 01440-2781
Phone (978) 630-4918

Other names 1

  • Ms. Diane M. Barrieau Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20240529000834 MA Practitioner - Mental Health Counselor 2264874874 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Education

Practice roles

OrganizationSpecialtyStatusNew patients
Youth Opportunities Upheld, Inc. CurrentSince Apr 3, 2024 Accepting new patients

Locations

205 School St
Ste 202
Gardner, MA 01440
Phone (978) 632-2120

135 Gold Star Blvd
Worcester, MA 01606
Phone (508) 459-6400

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/youinc/r4/

Organizations & group practices 2

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": "1503619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1184141632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 SCHOOL ST STE 202",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014402781",
            "telephone_number": "978-630-4918",
            "fax_number": "978-630-3049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 SCHOOL ST. #202",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "01440",
            "telephone_number": "978-630-4918",
            "fax_number": "978-630-3049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DIANE",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "M.ED.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-25",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "BARRIEAU",
            "middle_name": "M.",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gardner, MA

Sources for this page

Verify at the official NPI Registry.