Diana Marie Medina, LCAS, LCSWA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

P015340 Issued in NC

Practice address

2000 Neuse Blvd
New Bern, NC 28560-3449

Phone

(252) 633-8204

NPI assigned

Mar 15, 2019

Last updated

Aug 6, 2021By 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 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Easter Seals Ucp North Carolina & Virginia, Inc.

  • Pharmacy
  • New Bern, NC
  • NPI 1013769629
  NPD (past)
• Pride in North Carolina, LLC

  • Community/Behavioral Health Agency
  • Jacksonville, NC
  • NPI 1821136581

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1552608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1871052290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 NEW RIVER DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285406006",
            "telephone_number": "910-545-9944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 NEUSE BLVD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285603449",
            "telephone_number": "252-633-8204"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Branchwood Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "NC",
            "postal_code": "285465919",
            "country_code": "US",
            "telephone_number": "910-938-9833",
            "fax_number": "910-938-9835",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 N Secrest St",
            "address_purpose": "LOCATION",
            "city": "Kinston",
            "state": "NC",
            "postal_code": "285015369",
            "country_code": "US",
            "telephone_number": "252-686-5062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "DIANA",
        "middle_name": "MARIE",
        "credential": "LCAS, LCSWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-15",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-24929",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-4929",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "P015340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Med First Immediate Care & Family Practice, PA
• Med First Immediate Care & Family Practice, PA
• Medic Home Equipment
• Itzel Medina-Medrano
• Carlo Alessandro Medina
• Bettina Bass Meekins, MD
• Lisa Meeks, MM, MA, CCC-SLP
• John Francis Mella, PT, DPT, CSCS
• Kathryn Melton
• Kasey A Melvin, M.A.

• Mental Health Counselor in New Bern, NC
• Providers in New Bern, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; 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.