Diana Gale Ham, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

60397 Issued in TX

Practice address

1800 E Broad St
Annex C
Mansfield, TX 76063-3411

Phone

(817) 812-2880

NPI assigned

Oct 4, 2017

Last updated

Oct 11, 2017By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Logos Services LLC

  • Community/Behavioral Health Agency
  • Keller, TX
  • NPI 1881852952
  Medicare reassignment NPD
• Logos Iop, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Arlington, TX
  • NPI 1144006503

  Professional

  NPD (past)

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

{
    "created_epoch": "1507075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507680000000",
    "number": "1770093718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5751 PARK VISTA CIRCLE",
            "address_2": "SUITE 101",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762445607",
            "telephone_number": "817-812-2880",
            "fax_number": "817-812-3096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 E BROAD ST",
            "address_2": "ANNEX C",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633411",
            "telephone_number": "817-812-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAM",
        "first_name": "DIANA",
        "middle_name": "GALE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-04",
        "last_updated": "2017-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "60397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelti Haley, FNP-C
• Jo A Hall-Gomes, PHARM D
• Autumn Rhea Hall, FNP-C
• Kerry Hall, RN, RNFA, CNOR
• Marty Jay Hall, D.C.
• Hamilton County Hospital District (Avir at Mansfield)
• Blane Reynolds Hamilton, D.M.D
• Randolph W Hamilton III, DMD
• Simone Anne Hamilton
• Sandi Lee Hamm, DDS

• Professional Counselor in Mansfield, TX
• Providers in Mansfield, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2017; 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.