Individual provider Active NPI

Diane Marie Wilson, MSW

  • Clinical Social Worker
  • Norman, OK
National Provider Identifier
1184811564
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
448 36TH Ave NW Ste 101
Norman, OK 73072-4743
Phone
(405) 573-9905
NPI assigned
Sep 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary
Counselor 101Y00000X

Addresses

Primary practice location

448 36TH Ave NW Ste 101
Norman, OK 73072-4743

Mailing address

448 36TH Ave NW Ste 101
Norman, OK 73072-4743
Phone (405) 573-9905

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20231009001704 OK Practitioner - Clinical Social Worker 3870948003 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Millennium Medical Services, LLCGroup PAC ID 6204730856, 25 clinicians

Practice addresses (Care Compare)

508 Man O War CT
Edmond, OK 73025-9512
Phone (405) 623-0509

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Medical Services, L.L.C. Clinical CurrentSince Aug 15, 2023 Accepting new patients

Locations

448 36th Ave NW
Ste 101
Norman, OK 73072
Phone (405) 623-1624

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": "1190937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1184811564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "448 36TH AVE NW STE 101",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730724743",
            "telephone_number": "405-573-9905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "448 36TH AVE NW STE 101",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730724743",
            "telephone_number": "405-573-9905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DIANE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-28",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

Verify at the official NPI Registry.