NPIMap

Organization Active NPI

Diane Clark LLC

  • Clinical Social Worker
  • Manhattan, KS
National Provider Identifier
1194358895
Registry record updated Feb 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
DIANE CLARK LLC
Practice address
1445 Anderson Ave
Manhattan, KS 66502-4030
Phone
(785) 333-3793
NPI assigned
Feb 20, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2020

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

Authorized official

Name
Diane Clark, LSCSW
Title
Owner
Phone
(785) 333-3793

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

1445 Anderson Ave
Manhattan, KS 66502-4030

Mailing address

1445 Anderson Ave
Manhattan, KS 66502-4030
Phone (785) 333-3793

Other names 1

  • Ethos Therapy and Life Coaching Doing business as

National Provider Directory

National Provider Directory

Locations

1445 Anderson Ave
Manhattan, KS 66502
Phone (785) 333-3793

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1582156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582156800000",
    "number": "1194358895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 ANDERSON AVE",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665024030",
            "telephone_number": "785-333-3793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 ANDERSON AVE",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665024030",
            "telephone_number": "785-333-3793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIANE CLARK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-20",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "785-333-3793",
        "authorized_official_credential": "LSCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ethos Therapy and Life Coaching",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manhattan, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.