Active NPI
Diana J Walz, LCSW
- Clinical Social Worker
- Columbia, MO
National Provider Identifier
1023076841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW005946
- Practice address
- 601 Business Loop 70 W
Columbia, MO 65203-2546 - Phone
- (573) 884-1400
- NPI assigned
- May 2, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW005946 | MO | Primary |
Addresses
Primary practice location
601 Business Loop 70 W
Columbia, MO 65203-2546
Mailing address
PO Box 7687
Columbia, MO 65205-7687
Phone (573) 882-2259
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00130709 | Other | MO | RR MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Nov 1, 2017 through Nov 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW005946 | MO | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Burrell, Inc. | Past | Accepting new patients | |
| Curators of the University of Missouri | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Springfield, MO
- NPI 1275541740
-
- Multi-Specialty Clinic/Center
- Columbia, MO
- NPI 1477587152
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023076841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7687",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652057687",
"telephone_number": "573-882-2259",
"fax_number": "573-884-8526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 BUSINESS LOOP 70 W",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652032546",
"telephone_number": "573-884-1400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALZ",
"first_name": "DIANA",
"middle_name": "J",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MO",
"license": "SW005946",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00130709",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Columbia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.