Diana Manor, MS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

002783 Issued in NY

Practice address

1919 Middle Country Road
Suite 201
Centereach, NY 11720

Phone

(631) 921-2208

NPI assigned

Feb 6, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Diana Lish Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659411254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CLUBHOUSE COURT",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "11727",
            "telephone_number": "631-736-6643",
            "fax_number": "631-736-6643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 MIDDLE COUNTRY ROAD",
            "address_2": "SUITE 201",
            "city": "CENTEREACH",
            "state": "NY",
            "postal_code": "11720",
            "telephone_number": "631-921-2208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANOR",
        "first_name": "DIANA",
        "name_prefix": "Mrs.",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "002783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "LISH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Mental Health Counselor in Centereach, NY
• Providers in Centereach, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.