Active NPI
Diane Mountzouris, LCADC, LPC
- Professional Counselor
- Jackson, NJ
National Provider Identifier
1982966321
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 37PC00449100
- Practice address
- 510 Whitesville Rd
Jackson, NJ 08527-5044 - Phone
- (732) 766-9016
- NPI assigned
- Jun 12, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 37LC00138000 | NJ | |
| Professional Counselor | 101YP2500X | 37PC00449100 | NJ | Primary |
Addresses
Primary practice location
510 Whitesville Rd
Jackson, NJ 08527-5044
Mailing address
510 Whitesville Rd
Jackson, NJ 08527-5044
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 |
|---|---|---|---|
| 37LC00138000 | NJ | MD | Addiction (Substance Use Disorder) Counselor |
| 37PC00449100 | NJ | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339459200000",
"number": "1982966321",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "510 WHITESVILLE RD",
"city": "JACKSON",
"state": "NJ",
"postal_code": "085275044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 WHITESVILLE RD",
"city": "JACKSON",
"state": "NJ",
"postal_code": "085275044",
"telephone_number": "732-766-9016"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOUNTZOURIS",
"first_name": "DIANE",
"credential": "LCADC, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-12",
"last_updated": "2012-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NJ",
"license": "37LC00138000",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NJ",
"license": "37PC00449100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.