Individual provider Active NPI

Diana Lynn Morales, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1104219534
Registry record updated Mar 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
150012719 Issued in IL
Practice address
820 S Damen Ave
Chicago, IL 60612-3728
Phone
(312) 569-7012
Fax
(773) 826-2793
NPI assigned
Mar 10, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 150012719 IL Primary

Addresses

Primary practice location

820 S Damen Ave
Chicago, IL 60612-3728

Mailing address

428 Wisconsin Ave
Unit 2N
Oak Park, IL 60302-3686
Phone (312) 569-7012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
150012719ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1425945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425945600000",
    "number": "1104219534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 WISCONSIN AVE",
            "address_2": "UNIT 2N",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603023686",
            "telephone_number": "312-569-7012",
            "fax_number": "773-826-2793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 S DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123728",
            "telephone_number": "312-569-7012",
            "fax_number": "773-826-2793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALES",
        "first_name": "DIANA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-10",
        "last_updated": "2015-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "150012719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.