Active NPI
Diana Kay Wallace, L.I.M.H.P.
- Mental Health Counselor
- North Platte, NE
National Provider Identifier
1457433146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 583
- Practice address
- 518 S Jeffers St Ste 7
North Platte, NE 69101-5370 - Phone
- (308) 221-2141
- Fax
- (308) 221-2141
- NPI assigned
- Oct 20, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 700 | NE | |
| Mental Health Counselor | 101YM0800X | 583 | NE | Primary |
| Marriage & Family Therapist | 106H00000X | 265 | NE |
Addresses
Primary practice location
518 S Jeffers St Ste 7
North Platte, NE 69101-5370
Mailing address
518 S Jeffers St Ste 7
North Platte, NE 69101-5370
Phone (308) 221-2141
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 82473 | Other | NE | BLUE CROSS BLUE SHIELD OF NEBRASKA |
| 10025816000 | Medicaid | NE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 583 | NE | MD | Addiction (Substance Use Disorder) Counselor |
| 700 | NE | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Abide in Hope Counseling LLC | Mental Health | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Marriage & Family Therapist
- North Platte, NE
- NPI 1841518933
Mental Health
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265846400000",
"number": "1457433146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "518 S JEFFERS ST STE 7",
"city": "NORTH PLATTE",
"state": "NE",
"postal_code": "691015370",
"telephone_number": "308-221-2141",
"fax_number": "308-221-2141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "518 S JEFFERS ST STE 7",
"city": "NORTH PLATTE",
"state": "NE",
"postal_code": "691015370",
"telephone_number": "308-221-2141",
"fax_number": "308-221-2141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLACE",
"first_name": "DIANA",
"middle_name": "KAY",
"credential": "L.I.M.H.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-20",
"last_updated": "2010-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NE",
"license": "700",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NE",
"license": "583",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NE",
"license": "265",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD OF NEBRASKA",
"identifier": "82473",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025816000",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Platte, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.