Individual provider Active NPI

Diane Jane Gates, MA, LPC

  • Professional Counselor
  • Paoli, PA
National Provider Identifier
1396971719
Registry record updated Jun 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC005145 Issued in PA
Practice address
1440 Russell Rd
Paoli, PA 19301-1236
Phone
(610) 644-6464
Fax
(610) 644-4066
NPI assigned
Jun 1, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC005145 PA Primary

Addresses

Primary practice location

1440 Russell Rd
Paoli, PA 19301-1236

Mailing address

1440 Russell Rd
Paoli, PA 19301-1236
Phone (610) 644-6464

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
Master of Arts

State licenses

LicenseStateTypeSpecialty
PC005145PAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1243814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243814400000",
    "number": "1396971719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 RUSSELL RD",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011236",
            "telephone_number": "610-644-6464",
            "fax_number": "610-644-4066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 RUSSELL RD",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011236",
            "telephone_number": "610-644-6464",
            "fax_number": "610-644-4066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATES",
        "first_name": "DIANE",
        "middle_name": "JANE",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-01",
        "last_updated": "2009-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC005145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paoli, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2009; 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.