Active NPI
Diane Patrice Gammon, LPC-MHSP
- Mental Health Counselor
- Murfreesboro, TN
National Provider Identifier
1477260321
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 4895
- Practice address
- 745 S Church St Ste 805
Murfreesboro, TN 37130-4983 - Phone
- (615) 556-8406
- Fax
- (615) 713-3024
- NPI assigned
- Oct 31, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 4895 | TN | Primary |
Addresses
Primary practice location
745 S Church St Ste 805
Murfreesboro, TN 37130-4983
Mailing address
PO Box 11865
Murfreesboro, TN 37129-0038
Phone (615) 730-2118
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4895 | TN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667174400000",
"number": "1477260321",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 11865",
"city": "MURFREESBORO",
"state": "TN",
"postal_code": "371290038",
"telephone_number": "615-730-2118",
"fax_number": "615-713-3024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "745 S CHURCH ST STE 805",
"city": "MURFREESBORO",
"state": "TN",
"postal_code": "371304983",
"telephone_number": "615-556-8406",
"fax_number": "615-713-3024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAMMON",
"first_name": "DIANE",
"middle_name": "PATRICE",
"credential": "LPC-MHSP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-31",
"last_updated": "2022-10-31",
"certification_date": "2022-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TN",
"license": "4895",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Murfreesboro, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.