Diandra Entler, MS, LCSW, CCLS

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.023166 Issued in IL

Practice address

1209 W Diversey Pkwy Unit G2
Chicago, IL 60614-1201

Phone

(312) 725-4879

NPI assigned

Aug 6, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rooted Therapeutics

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1124765896
  NPD Authorized official
• Renew You Counseling Center LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
  • NPI 1750807749
  NPD

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

{
    "created_epoch": "1628208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1235803784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 W DIVERSEY PKWY UNIT G2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141201",
            "telephone_number": "312-725-4879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 W DIVERSEY PKWY UNIT G2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141201",
            "telephone_number": "312-725-4879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENTLER",
        "first_name": "DIANDRA",
        "credential": "MS, LCSW, CCLS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-06",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.023166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW LICENSE",
            "identifier": "149.023166",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anja Ensio, APN
• Ensoleille Behavioral Health Inc
• ENT Surgery Care Center LLC
• Jack C. Enter Jr., PA-C
• Entertainment Psychology Inc
• Hannah Entner
• Entopy Research LLC
• Entrepreneur Enterprizez (Elderly Love Home Care, LLC)
• Entropy Physiotherapy and Wellness LLC
• Envision Counseling PLLC (Gracie Bates-Davis)

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; 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.