Individual provider Active NPI

Patrice H. Dihle, LCSW-C

  • Clinical Social Worker
  • Frederick, MD
National Provider Identifier
1174688584
Registry record updated Aug 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
07658 Issued in MD
Practice address
130 Thomas Johnson Dr
Ste 3
Frederick, MD 21702-4584
Phone
(301) 695-5222
Fax
(301) 695-5227
NPI assigned
Dec 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2019

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 07658 MD Primary

Addresses

Primary practice location

130 Thomas Johnson Dr
Ste 3
Frederick, MD 21702-4584

Mailing address

PO Box 1174
Frederick, MD 21702-0174
Phone (301) 695-5222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20070326000457 MD Practitioner - Clinical Social Worker 3173627460 Practice locations: Frederick, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

130 Thomas Johnson Dr
Suite 3
Frederick, MD 21702-4584
Phone (301) 695-5222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
07658MDMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1174688584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1174",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217020174",
            "telephone_number": "301-695-5222",
            "fax_number": "301-695-5227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 THOMAS JOHNSON DR",
            "address_2": "STE 3",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024584",
            "telephone_number": "301-695-5222",
            "fax_number": "301-695-5227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIHLE",
        "first_name": "PATRICE",
        "middle_name": "H.",
        "name_prefix": "Ms.",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "07658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.