Diana Sue Pack, MA, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH10940 Issued in FL

Practice address

1600 W Eau Gallie Blvd Ste 201D
Melbourne, FL 32935

Phone

(321) 604-9780

Fax

(321) 802-6616

NPI assigned

May 9, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531872000000",
    "number": "1346299054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W EAU GALLIE BLVD STE 201D",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329354149",
            "telephone_number": "321-604-9780",
            "fax_number": "321-802-6616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W EAU GALLIE BLVD STE 201D",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "32935",
            "telephone_number": "321-604-9780",
            "fax_number": "321-802-6616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACK",
        "first_name": "DIANA",
        "middle_name": "SUE",
        "name_prefix": "Ms.",
        "credential": "MA, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-09",
        "last_updated": "2018-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH10940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• P.a.M. Care Inc.
• P&a Special Services LLC
• Sukanya Pachaidee, MD
• Pacifico National II Inc (AmEx Pharma Lab)
• Pacifico National Inc (Amex Pharmacy)
• Julie Pack
• David J Packey, M.D. PH.D
• Zindy Padilla, OTA
• Elizabeth Paffenroth
• Jennifer Pagan Pallens, M.D.

• Mental Health Counselor in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; 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.