Active NPI
Charisse Renee Diaz, LMHC
- Mental Health Counselor
- Palm Harbor, FL
National Provider Identifier
1295144699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH13291
- Practice address
- 2708 Alternate 19 North
Suite 507-6
Palm Harbor, FL 34683 - Phone
- (813) 601-0595
- NPI assigned
- Aug 11, 2014
- Last updated
- Jun 24, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 | MH13291 | FL | Primary |
Addresses
Primary practice location
2708 Alternate 19 North
Suite 507-6
Palm Harbor, FL 34683
Mailing address
2708 Alternate 19 North
Suite 507-6
Palm Harbor, FL 34683
Phone (813) 601-0595
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2011
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2868 Living Coral Dr
Odessa, FL 33556-5123
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mindmetrics | Mental Health | Current | Accepting new patients |
Locations
3607 Alt 19
Palm Harbor, FL 34683
Phone (727) 732-4305
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.
-
- Mental Health Counselor
- Palm Harbor, FL
- NPI 1477302727
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466726400000",
"number": "1295144699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2708 ALTERNATE 19 NORTH",
"address_2": "SUITE 507-6",
"city": "PALM HARBOR",
"state": "FL",
"postal_code": "34683",
"telephone_number": "813-601-0595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2708 ALTERNATE 19 NORTH",
"address_2": "SUITE 507-6",
"city": "PALM HARBOR",
"state": "FL",
"postal_code": "34683",
"telephone_number": "813-601-0595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "CHARISSE",
"middle_name": "RENEE",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-11",
"last_updated": "2016-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH13291",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Harbor, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.