Individual provider Active NPI

Diana De Peyster Landers, LMFTA

  • Marriage & Family Therapist
  • Charlotte, NC
National Provider Identifier
1679254759
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
12528A Issued in NC
Practice address
11020 S Tryon St Ste 408
Charlotte, NC 28273-6662
Phone
(980) 236-1660
NPI assigned
Jul 31, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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 12528A NC Primary

Addresses

Primary practice location

11020 S Tryon St Ste 408
Charlotte, NC 28273-6662

Mailing address

6165 Caseys Side Way
Fort Mill, SC 29708-6434

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

LicenseStateTypeSpecialty
12528ANCMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Raymond Castillo, PLLC CurrentSince Aug 6, 2023 Accepting new patients

Locations

11020 S Tryon St
Ste 408
Charlotte, NC 28273
Phone (980) 236-1660

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1679254759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6165 CASEYS SIDE WAY",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297086434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11020 S TRYON ST STE 408",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282736662",
            "telephone_number": "980-236-1660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDERS",
        "first_name": "DIANA",
        "middle_name": "DE PEYSTER",
        "credential": "LMFTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-31",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "12528A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.