Laura Jean Diffendal, PCC-S

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E4139 Issued in OH

Practice address

20525 Center Ridge Rd Ste 520
Rocky River, OH 44116-3424

Phone

(216) 978-1924

NPI assigned

Jul 2, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284681600000",
    "number": "1679770614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1297 SAINT CHARLES AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441072532",
            "telephone_number": "216-978-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20525 CENTER RIDGE RD STE 520",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441163424",
            "telephone_number": "216-978-1924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIFFENDAL",
        "first_name": "LAURA",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "PCC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-02",
        "last_updated": "2010-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E4139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Rocky River, OH
• Providers in Rocky River, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.