Jeremy W Didier, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

12387 Issued in KS

Practice address

7501 College Blvd Ste 250
Overland Park, KS 66210-2505

Phone

(913) 451-8550

NPI assigned

Nov 23, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 3, 2024 through Jan 3, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Jordan Psychological Assessment Center LLC

  • Clinical Psychologist
  • Overland Park, KS
  • NPI 1093123390
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1637625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1063179232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11700 W 143RD ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662219571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7501 COLLEGE BLVD STE 250",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102505",
            "telephone_number": "913-451-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIDIER",
        "first_name": "JEREMY",
        "middle_name": "W",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-23",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "12387",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "12387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kameron Micheal Dickerson
• Dickson Diveley Midwest Orthopaedic Clinic LLC
• Amber Joy Dickson, LPC
• Dana Faye Dickson, PA
• Marissa A Dickson, PHARMD
• Allison Diebolt, OTR/L
• Anna Diec
• Paul G Diederich, M.D.
• Rhett Diefendorf
• Jackson L Diel, DPT

• Clinical Social Worker in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Clinical Social Worker in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.