Individual provider Active NPI

Diane Sue Vancleave, PH.D, MSSW

  • Clinical Social Worker
  • Evansville, IN
National Provider Identifier
1245483395
Registry record updated Nov 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
340000182A Issued in IN
Practice address
4770 Covert Ave
Evansville, IN 47714-5617
Phone
(812) 475-3420
NPI assigned
Nov 2, 2008
Last updated
Nov 2, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2008

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 340000182A IN Primary
Marriage & Family Therapist 106H00000X 35001309A IN

Addresses

Primary practice location

4770 Covert Ave
Evansville, IN 47714-5617

Mailing address

4770 Covert Ave
Evansville, IN 47714-5617
Phone (812) 475-3420

Other identifiers 2

IdentifierTypeStateIssuer
34000182AOtherINCLINICAL SOCIAL WORKER
35001309AOtherINMARRIAGE & FAMILY THERAPIST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
340000182AINMDClinical Social Worker
35001309AINMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Cross Pointe Center, LLC Clinical Past Accepting new patients
Deaconess Cross Pointe Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1225584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225584000000",
    "number": "1245483395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4770 COVERT AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477145617",
            "telephone_number": "812-475-3420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4770 COVERT AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477145617",
            "telephone_number": "812-475-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCLEAVE",
        "first_name": "DIANE",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "PH.D, MSSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-02",
        "last_updated": "2008-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "340000182A",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "35001309A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL SOCIAL WORKER",
            "identifier": "34000182A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARRIAGE & FAMILY THERAPIST",
            "identifier": "35001309A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2008; 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.