Active NPI
Mary Janelle Disney, PHD
- Professional Counselor
- Lake Charles, LA
National Provider Identifier
1750540332
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 238
- Practice address
- 840 West Bayou Pines
Suite B
Lake Charles, LA 70601 - Phone
- (337) 310-0153
- Fax
- (337) 310-0202
- NPI assigned
- Jun 9, 2008
- Last updated
- Jun 9, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 238 | LA | Primary |
| Professional Counselor | 101YP2500X | LPC001933 | GA | |
| Marriage & Family Therapist | 106H00000X | MFT127 | LA |
Addresses
Primary practice location
840 West Bayou Pines
Suite B
Lake Charles, LA 70601
Mailing address
840 West Bayou Pines
Suite B
Lake Charles, LA 70601
Phone (337) 310-0153
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC001933 | GA | MD | Professional Counselor |
| 238 | LA | MD | Professional Counselor |
| MFT127 | LA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Psychiatric Services, LLC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Counselor
- Lake Charles, LA
- NPI 1093709461
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212969600000",
"number": "1750540332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "840 WEST BAYOU PINES",
"address_2": "SUITE B",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "70601",
"telephone_number": "337-310-0153",
"fax_number": "337-310-0202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "840 WEST BAYOU PINES",
"address_2": "SUITE B",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "70601",
"telephone_number": "337-310-0153",
"fax_number": "337-310-0202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DISNEY",
"first_name": "MARY",
"middle_name": "JANELLE",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-09",
"last_updated": "2008-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "LA",
"license": "238",
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC001933",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "LA",
"license": "MFT127",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Charles, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.