MEDICARE: MS. DIANNE MARIE PELA MAPC, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	LPC11996	AZ
2	101YM0800X	Mental Health Counselor	LPC11996	AZ

General Provider Information

NPI Number	:	1427159789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DIANNE MARIE PELA MAPC, LPC

Provider Business Mailing Address
First Line	:	13819 N 42ND DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85053-5392
Country	:	US
Telephone Number	:	602-866-1558
Fax Number	:	602-866-1558

Provider Business Practice Location Address
First Line	:	2400 E ARIZONA BILTMORE CIR
Second Line	:	BLDG. 4, STE. 2430
City	:	PHOENIX
State	:	AZ
Zip	:	85016-2107
Country	:	US
Telephone Number	:	480-266-9546
Fax Number	:	602-381-9907

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	09/11/2025

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