Individual provider Active NPI

Dianne Ladon Phillips-Miller, PH.D.

  • Counseling Psychologist
  • Moscow, ID
National Provider Identifier
1336106830
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
PSY 288 Issued in ID
Practice address
814 S Washington St
Moscow, ID 83843-3049
Phone
(208) 882-0619
Fax
(208) 882-4774
NPI assigned
Apr 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X PSY 288 ID Primary

Addresses

Primary practice location

814 S Washington St
Moscow, ID 83843-3049

Mailing address

814 S Washington St
Moscow, ID 83843-3049
Phone (208) 882-0619

Other identifiers 3

IdentifierTypeStateIssuer
P9205OtherIDAPS HEALTHCARE
N4460OtherIDBLUE CROSS OF IDAHO
CBH2228116OtherIDCIGNA

Other names 1

  • Dianne Ladon Wimberley Former name

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY 288IDMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1336106830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 S WASHINGTON ST",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838433049",
            "telephone_number": "208-882-0619",
            "fax_number": "208-882-4774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 S WASHINGTON ST",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838433049",
            "telephone_number": "208-882-0619",
            "fax_number": "208-882-4774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS-MILLER",
        "first_name": "DIANNE",
        "middle_name": "LADON",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-27",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "ID",
            "license": "PSY 288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APS HEALTHCARE",
            "identifier": "P9205",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "N4460",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "CBH2228116",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANNE",
            "last_name": "WIMBERLEY",
            "middle_name": "LADON",
            "credential": "PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Moscow, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.