Diane M Threedy

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

943008720 Issued in UT

Practice address

660 S 200 E
Salt Lake City, UT 84111-3835

Phone

(801) 355-1528

Fax

(801) 364-4085

NPI assigned

Nov 15, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Diane Threedy Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1289779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289779200000",
    "number": "1578864096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1371 MURPHYS LN",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841062931",
            "telephone_number": "801-355-1528",
            "fax_number": "801-364-4085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 S 200 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841113835",
            "telephone_number": "801-355-1528",
            "fax_number": "801-364-4085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THREEDY",
        "first_name": "DIANE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-15",
        "last_updated": "2010-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "UT",
            "license": "943008720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "943008720",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "THREEDY",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Addiction (Substance Use Disorder) Counselor in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Addiction (Substance Use Disorder) Counselor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.

Verify at the official NPI Registry.