Healthcare Provider Details

I. General information

NPI: 1093039927
Provider Name (Legal Business Name): DIANA E MCCARLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DIANA BUSBIN

II. Dates (important events)

Enumeration Date: 03/22/2010
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7355 US HIGHWAY 98 N
LAKELAND FL
33809-2102
US

IV. Provider business mailing address

1101 W 40TH ST UNIT 2225
CHATTANOOGA TN
37409-1379
US

V. Phone/Fax

Practice location:
  • Phone: 877-358-2998
  • Fax: 423-405-6346
Mailing address:
  • Phone: 877-358-2998
  • Fax: 423-405-6346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN84711
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: