Healthcare Provider Details

I. General information

NPI: 1811121536
Provider Name (Legal Business Name): DIANA KAY CANFIELD MS, LCPC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2009
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3635 E INVERNESS AVE STE 109
MESA AZ
85206-3848
US

IV. Provider business mailing address

3635 E INVERNESS AVE STE 109
MESA AZ
85206-3848
US

V. Phone/Fax

Practice location:
  • Phone: 480-369-0604
  • Fax:
Mailing address:
  • Phone: 480-369-0604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLCPC-4864
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC-5571T
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: