Diane Lisa Bailey, PHD, LPC, CRC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

PC004216 Issued in PA

Practice address

2209 Quarry Dr
Suite C36
West Lawn, PA 19609-1155

Phone

(610) 441-3378

NPI assigned

Jul 10, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1881628469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3644 MOUNTAIN RD",
            "city": "HAMBURG",
            "state": "PA",
            "postal_code": "195267939",
            "telephone_number": "610-441-3378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2209 QUARRY DR",
            "address_2": "SUITE C36",
            "city": "WEST LAWN",
            "state": "PA",
            "postal_code": "196091155",
            "telephone_number": "610-441-3378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "DIANE",
        "middle_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "PHD, LPC, CRC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "3880",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC004216",
            "primary": true
        },
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": "12561",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6105074",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.

Verify at the official NPI Registry.