Diana Elaine Kandilakis, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC1529 Issued in ME

Practice address

23 Jewett Ave
South Berwick, ME 03908-1109

Phone

(603) 312-1820

Fax

(207) 985-1281

NPI assigned

Sep 26, 2008

Last updated

Nov 19, 2013By 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

Other names 1

• Ms. Diana Elaine Delzoppo Former name

Medicare fee-for-service enrollment

Enrolled in MA, ME2 enrollments

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 2

Specialty

Mental Health Counselor

Education

Other, 1995

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1222387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384819200000",
    "number": "1982854998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 JEWETT AVE",
            "city": "SOUTH BERWICK",
            "state": "ME",
            "postal_code": "039081109",
            "telephone_number": "603-312-1820",
            "fax_number": "207-985-1281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 JEWETT AVE",
            "city": "SOUTH BERWICK",
            "state": "ME",
            "postal_code": "039081109",
            "telephone_number": "603-312-1820",
            "fax_number": "207-985-1281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANDILAKIS",
        "first_name": "DIANA",
        "middle_name": "ELAINE",
        "name_prefix": "Ms.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-26",
        "last_updated": "2013-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ME",
            "license": "CC1529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "DELZOPPO",
            "middle_name": "ELAINE",
            "prefix": "MS.",
            "credential": "LCPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Morgan Fabreienne Dee Harrison
• Sarah Heffernan
• Lydia Higgins
• Nickolas Cameron Hutchings, PHARMD
• Chiedza G Jokonya, MD
• Thomas Emerson Kent, DPT
• Keri Fernald, LLC
• Michael C Kumin, MD
• Seth C Laflamme, D.C.
• Dagmar Lamberts, LICSW

• Mental Health Counselor in South Berwick, ME
• Providers in South Berwick, ME by specialty
• Mental Health Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.