Diane Gail Matz, LMSW – Clinical Social Worker

Key facts

NPI: 1104557628
Entity type: Individual (NPI type 1)
Primary specialty: Clinical Social Worker 1041C0700X
License: 6801094507 (MI)
Practice address: 17461 Allen Rd
Melvindale, MI 48122-1026
Phone: (313) 920-8771
NPI assigned: Jun 24, 2022
Sex: Female
Sole proprietor: Yes

Organizations & group practices 1

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.

Dimensions of Wellness, Inc., a Nonprofit Corporation Psychiatry Physician · Melvindale, MI · NPI 1942840731

Medicare reassignment Care Compare group NPD MI · SOCIAL WORKER

Medicare Care Compare profile

Specialty: Clinical Social Worker
Education: Other, 2012
Medicare assignment: May accept Medicare assignment
Group practices: Dimensions of Wellness Inc a Nonprofit Corporation (4 clinicians)

Practice addresses (Care Compare)

17461 Allen Rd
Melvindale, MI 48122-1026
Phone (313) 920-8771

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MI
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20240125003387	MI	Practitioner - Clinical Social Worker	9133572126	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes

Practice roles

Organization	Specialty	Status	New patients
Dimensions of Wellness, Inc., a Nonprofit Corporation	Social Worker	Current since Jan 16, 2024	Accepting new patients

Locations

17461 Allen Rd
Melvindale, MI 48122
Phone (313) 364-9042

2250 N Monroe St
Monroe, MI 48162
Phone (313) 920-8771

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Clinical Social Worker	1041C0700X	6801094507	MI	Yes

Addresses

Primary practice location

17461 Allen Rd
Melvindale, MI 48122-1026

Mailing address

548 E Huron River Dr
Belleville, MI 48111-3666
Phone (734) 612-2433

Electronic endpoints

Type	Endpoint	Use	Affiliation
CONNECT URL	info@dimensionsofwellness.org	Direct

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 24, 2022.

{
    "created_epoch": "1656028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1104557628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "548 E HURON RIVER DR",
            "city": "BELLEVILLE",
            "state": "MI",
            "postal_code": "481113666",
            "telephone_number": "734-612-2433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17461 ALLEN RD",
            "city": "MELVINDALE",
            "state": "MI",
            "postal_code": "481221026",
            "telephone_number": "313-920-8771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATZ",
        "first_name": "DIANE",
        "middle_name": "GAIL",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-24",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801094507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "info@dimensionsofwellness.org",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "17461 Allen Rd",
            "city": "Melvindale",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481221026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Melvindale, MI

All providers in Melvindale, MI · Clinical Social Worker in Michigan

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2022. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.