Diane Rokita Pridgen, ACSW,LCSW

Individual provider Active NPI Professional Counselor · Halifax, NC

NPI 1992865620 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1992865620
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
C000362 (NC)
Practice address
19 North Dobbs Street
Halifax, NC 27839-0010
Phone
(252) 583-5021
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
C000362NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
County of Halifax Past
since Oct 1, 2014
Accepting new patients
Halifax County Health Department Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X C000362 NC Yes

Addresses

Primary practice location

19 North Dobbs Street
Halifax, NC 27839-0010

Mailing address

19 North Dobbs Street
Halifax, NC 27839-0010
Phone (252) 583-5021

Other providers in Halifax, NC

All providers in Halifax, NC · Professional Counselor in North Carolina

Sources for this page

Verify at the official NPI Registry.