Active NPI
Sandra Hall Diaz, LCSW
- Mental Health Counselor
- Ocean Springs, MS
National Provider Identifier
1801977921
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- C1885
- Practice address
- 310 W. Porter Ave
Ocean Springs, MS 39564 - Phone
- (228) 872-2011
- Fax
- (228) 872-3791
- NPI assigned
- Oct 17, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | C1885 | MS | Primary |
Addresses
Primary practice location
310 W. Porter Ave
Ocean Springs, MS 39564
Mailing address
310 W. Porter Ave
Ocean Springs, MS 39564
Phone (228) 872-2011
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0118148 | Medicaid | MS | |
| 62-51970 | Other | MS | MAIL HANDLERS BENEFIT PLA |
| SWL-3703000 | Other | NY | AMERICAN PROFESSIONAL AGE |
| C1885 | Other | MS | MS STATE LICENSE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C1885 | MS | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367798400000",
"number": "1801977921",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "310 W. PORTER AVE",
"city": "OCEAN SPRINGS",
"state": "MS",
"postal_code": "39564",
"telephone_number": "228-872-2011",
"fax_number": "228-872-3791"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 W. PORTER AVE",
"city": "OCEAN SPRINGS",
"state": "MS",
"postal_code": "39564",
"telephone_number": "228-872-2011",
"fax_number": "228-872-3791"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "SANDRA",
"middle_name": "HALL",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-17",
"last_updated": "2013-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MS",
"license": "C1885",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0118148",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAIL HANDLERS BENEFIT PLA",
"identifier": "62-51970",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN PROFESSIONAL AGE",
"identifier": "SWL-3703000",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MS STATE LICENSE",
"identifier": "C1885",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ocean Springs, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.