Individual provider Active NPI

Diana Wilder Lett, LCSW, LISAC

  • Clinical Social Worker
  • Tucson, AZ
National Provider Identifier
1154626810
Registry record updated Jan 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-13181 Issued in AZ
Practice address
2561 E Fort Lowell Rd
Suite 2
Tucson, AZ 85716-1540
Phone
(520) 977-0870
Fax
(520) 327-0229
NPI assigned
Jan 11, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LISAC-11858 AZ
Clinical Social Worker 1041C0700X LCSW-13181 AZ Primary

Addresses

Primary practice location

2561 E Fort Lowell Rd
Suite 2
Tucson, AZ 85716-1540

Mailing address

2561 E Fort Lowell Rd
Suite 2
Tucson, AZ 85716-1540
Phone (520) 977-0870

Other names 1

  • Diana Lett Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160113003055 AZ Practitioner - Clinical Social Worker 7416259098 Practice locations: Tucson, AZ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2561 E Fort Lowell Rd
Suite 2
Tucson, AZ 85716-1540
Phone (520) 977-0870

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LISAC-11858AZMDAddiction (Substance Use Disorder) Counselor
LCSW-13181AZMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1294704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294704000000",
    "number": "1154626810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2561 E FORT LOWELL RD",
            "address_2": "SUITE 2",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857161540",
            "telephone_number": "520-977-0870",
            "fax_number": "520-327-0229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2561 E FORT LOWELL RD",
            "address_2": "SUITE 2",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857161540",
            "telephone_number": "520-977-0870",
            "fax_number": "520-327-0229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LETT",
        "first_name": "DIANA",
        "middle_name": "WILDER",
        "credential": "LCSW, LISAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-11",
        "last_updated": "2011-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LISAC-11858",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-13181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "LETT",
            "credential": "LCSW, LISAC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.