Active NPI
Diana Keys
- Mental Health Counselor
- Dallas, GA
National Provider Identifier
1215338652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 110 Evans Mill Dr
Dallas, GA 30157-1622 - Phone
- (678) 395-1933
- NPI assigned
- Sep 4, 2014
- Sex
- Female
- Sole proprietor
- No
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 | GA | Primary |
Addresses
Primary practice location
110 Evans Mill Dr
Dallas, GA 30157-1622
Mailing address
975 Prickett LN
Douglasville, GA 30134-4682
Phone (678) 395-1933
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11111111 | Medicaid | GA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409788800000",
"number": "1215338652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "975 PRICKETT LN",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301344682",
"telephone_number": "678-395-1933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 EVANS MILL DR",
"city": "DALLAS",
"state": "GA",
"postal_code": "301571622",
"telephone_number": "678-395-1933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEYS",
"first_name": "DIANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-04",
"last_updated": "2014-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "GA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "11111111",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.