Individual provider Active NPI

Dianne Gadishaw

  • Mental Health Counselor
  • Miami, FL
National Provider Identifier
1487398806
Registry record updated Apr 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH20689 Issued in FL
Practice address
11715 SW 169TH Ter
Miami, FL 33177-2153
Phone
(786) 879-6082
NPI assigned
Apr 21, 2022
Last updated
Apr 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH20689 FL Primary

Addresses

Primary practice location

11715 SW 169TH Ter
Miami, FL 33177-2153

Mailing address

11715 SW 169TH Ter
Miami, FL 33177-2153
Phone (786) 879-6082

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL DianneGadishaw@gmail.com
CONNECT URL DianneGadishaw@gmail.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231202000786 FL Practitioner - Mental Health Counselor 7618325564 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH20689FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Thriveworks Clinical - Florida Inc Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Strongmind, PLLC PastSince Apr 17, 2022 Accepting new patients

Locations

4070 Herschel St
Ste 1
Jacksonville, FL 32210
Phone (239) 999-1029

4115 W Spruce St
Ste 205
Tampa, FL 33607
Phone (813) 413-4663

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1650499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1487398806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11715 SW 169TH TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331772153",
            "telephone_number": "786-879-6082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11715 SW 169TH TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331772153",
            "telephone_number": "786-879-6082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADISHAW",
        "first_name": "DIANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-21",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH20689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "DianneGadishaw@gmail.com",
            "affiliation": "N",
            "address_1": "11715 SW 169th Ter",
            "city": "Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331772153",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "DianneGadishaw@gmail.com",
            "affiliation": "N",
            "address_1": "11715 SW 169th Ter",
            "city": "Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331772153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.