Individual provider Active NPI

Dianna Sanderson, LMFT

  • Marriage & Family Therapist
  • Lake Worth, FL
National Provider Identifier
1528376274
Registry record updated Sep 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT2450 Issued in FL
Practice address
2311 10TH Ave N
Suite 5
Lake Worth, FL 33461-6605
Phone
(561) 533-0765
NPI assigned
Sep 15, 2010
Last updated
Sep 15, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MT2450 FL Primary

Addresses

Primary practice location

2311 10TH Ave N
Suite 5
Lake Worth, FL 33461-6605

Mailing address

2311 10TH Ave N
Suite 5
Lake Worth, FL 33461-6605

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
I20251120003073 FL Practitioner - Mental Health Counselor 7315439056 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCCD FL Psychiatry Services PAGroup PAC ID 4880064070, 751 clinicians

Practice addresses (Care Compare)

101 N Monroe St
Suite 800 Private Office 860
Tallahassee, FL 32301-1570
Phone (833) 351-8255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MT2450FLMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
MCCD FL Psychiatry Services PA CurrentSince Sep 15, 2025 Accepting new patients

Locations

1301 Riverplace Blvd
Jacksonville, FL 32207

101 N Monroe St
Ste 800
Tallahassee, FL 32301
Phone (321) 300-2108

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, 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": "1284508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284508800000",
    "number": "1528376274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 10TH AVE N",
            "address_2": "SUITE 5",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334616605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 10TH AVE N",
            "address_2": "SUITE 5",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334616605",
            "telephone_number": "561-533-0765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERSON",
        "first_name": "DIANNA",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-15",
        "last_updated": "2010-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT2450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

Verify at the official NPI Registry.