Diana Marie Smith, PHD, LPC-MH

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC MH 2025 Issued in SD

Practice address

6613 Eastridge Rd
Black Hawk, SD 57718-8335

Phone

(605) 431-8595

Fax

(605) 431-8595

NPI assigned

Jan 18, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Ms. Diana Marie Styles Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1750433629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6613 EASTRIDGE RD",
            "city": "BLACK HAWK",
            "state": "SD",
            "postal_code": "577188335",
            "telephone_number": "605-347-7560",
            "fax_number": "605-718-7595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6613 EASTRIDGE RD",
            "city": "BLACK HAWK",
            "state": "SD",
            "postal_code": "577188335",
            "telephone_number": "605-431-8595",
            "fax_number": "605-431-8595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DIANA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PHD, LPC-MH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "SD",
            "license": "LPC MH 2025",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SD",
            "license": "LPC MH 2025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6575393",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTA CARE",
            "identifier": "4997637",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BLUE CROSS",
            "identifier": "4997637",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "STYLES",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "LPC MH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Annemarie Johnson
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• Bryan M Satterwhite, MSW, CSW, PIP, QMHP
• Paula Shelley

• All providers in Black Hawk, SD
• Mental Health Counselor in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.