Active NPI
Gabrielle Dietz, LCSWC
- Social Worker
- Columbia, MD
National Provider Identifier
1164060794
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 6410 Dobbin Rd Ste F
Columbia, MD 21045-4774 - Phone
- (301) 246-0718
- NPI assigned
- Dec 13, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 25316 | MD | |
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
6410 Dobbin Rd Ste F
Columbia, MD 21045-4774
Mailing address
6410 Dobbin Rd Ste F
Columbia, MD 21045-4774
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD, DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- University of Maryland School of Medicine, 2019
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Pittsburgh, PA 15251
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25316 | MD | MD | Ambulatory Care Pharmacist |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695859200000",
"number": "1164060794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6410 DOBBIN RD STE F",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210454774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6410 DOBBIN RD STE F",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210454774",
"telephone_number": "301-246-0718"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIETZ",
"first_name": "GABRIELLE",
"credential": "LCSWC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-13",
"last_updated": "2023-09-28",
"certification_date": "2023-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "25316",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Columbia, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.