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Active NPI 1760067920 Individual Practitioner Female Practitioner

Jennifer Diaz , LPC, EDS

Counselor - Professional • Beverly, NJ

Public Directory Information & Medical Disclaimer

This profile is compiled from official public domain records provided by CMS and the NPPES registry. TRUE-MEDINFO is an independent reference directory and does not provide medical advice, diagnosis, or treatment recommendations. Always consult a licensed medical professional for personal health decisions.

Professional Overview & Biography Verified Profile Summary

Jennifer Diaz, LPC, EDS is a registered healthcare professional specializing in Counselor - Professional in Beverly, NJ. Official NPI practice address is registered at 644 MANOR RD.

Practice Location & Contact Primary Location

Practice Address

644 Manor Rd

Beverly, NJ 080101057

Telephone 2153916325
Associated Practice Facility / Clinic
🏢 Root To Vine Therapy Facility NPI 1699507210

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Beverly, NJ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 15.9 Yrs
Regional Practice Density
1 Specialists

Practicing in Beverly, NJ (4170 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-10-17
Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License NJ 37PC00944300

Definition to come...

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
📍
Updated Practice Location October 17, 2024

Registered at 644 MANOR RD, BEVERLY, NJ 080101057 (Tel: 2153916325)

👤
Provider Name / Credentials Updated October 17, 2024

Recorded as JENNIFER DIAZ, LPC, EDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 17, 2024

Counselor (License #37PC00944300 in NJ)

👤
Provider Name / Credentials Updated August 14, 2024

Recorded as JENNIFER DIAZ, LPC

📍
Updated Business Mailing Address October 26, 2022

Registered at 644 MANOR RD, BEVERLY, NJ 080101057 (Tel: 2153916325)

👤
Provider Name / Credentials Updated October 26, 2022

Recorded as JENNIFER DIAZ, LAC

✅
NPI Profile Active March 09, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location March 09, 2021

Registered at 7126 HAMILTON WAY, EASTAMPTON TOWNSHIP, NJ 080601681 (Tel: 2153916325)

📍
Updated Business Mailing Address March 09, 2021

Registered at 29 TALLWOOD LN, WILLINGBORO, NJ 080464101 (Tel: 2153916325)

👤
Provider Name / Credentials Updated March 09, 2021

Recorded as JENNIFER BLANKS, LAC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 09, 2021

Counselor

🟢
Initial NPI Registration & Enumeration March 09, 2021

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1760067920
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 09, 2021
Last Update: October 17, 2024
Sole Proprietor: No
Update or Correct Profile

Mailing Address

644 Manor Rd

Beverly, NJ 080101057

Phone: 2153916325

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.