Active NPI
Diane Detwiler-Zapp, LPC
- Mental Health Counselor
- Wickenburg, AZ
National Provider Identifier
1952480188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LPC-10453
- Practice address
- 315 W Apache St
Wickenburg, AZ 85390-1213 - Phone
- (623) 910-6246
- NPI assigned
- Nov 6, 2006
- Last updated
- Jul 9, 2007
- 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 | LPC-10453 | AZ | Primary |
Addresses
Primary practice location
315 W Apache St
Wickenburg, AZ 85390-1213
Mailing address
PO Box 1508
Wickenburg, AZ 85358-1508
Phone (623) 910-6246
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AZ0618640 | Other | AZ | AZ. BCBS |
| 837031 | Medicaid | AZ |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-10453 | AZ | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1952480188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1508",
"city": "WICKENBURG",
"state": "AZ",
"postal_code": "853581508",
"telephone_number": "623-910-6246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 W APACHE ST",
"city": "WICKENBURG",
"state": "AZ",
"postal_code": "853901213",
"telephone_number": "623-910-6246"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DETWILER-ZAPP",
"first_name": "DIANE",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-06",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AZ",
"license": "LPC-10453",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AZ. BCBS",
"identifier": "AZ0618640",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "837031",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wickenburg, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.