Mary Byers Diaz, LPC
Individual provider Active NPI Professional Counselor · Hackett, AR
NPI 1992049779 · NPPES record last updated Jun 8, 2016
Key facts
- NPI
- 1992049779
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- Practice address
- 1614 Jenson Rd
Hackett, AR 72937-4313 - Phone
- (479) 629-1521
- Fax
- (918) 649-3747
- NPI assigned
- Nov 19, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | Yes |
Addresses
Primary practice location
1614 Jenson Rd
Hackett, AR 72937-4313
Mailing address
1614 Jenson Rd
Hackett, AR 72937-4313
Phone (479) 629-1521
Other providers in Hackett, AR
- James R. Derrick
- Melissa Dawn Erwin
- Erin Goss
- Hackett Family Clinic, LLC
- Hackett School District
- Hackett School District
All providers in Hackett, AR · Professional Counselor in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.