Individual provider Active NPI

Diane Dahm

  • Clinical Social Worker
  • Albuquerque, NM
National Provider Identifier
1265752950
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW018371 Issued in PA
Practice address
120 Aliso Dr SE Ste G
Albuquerque, NM 87108-2693
Phone
(412) 423-8227
NPI assigned
Jun 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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 CW018371 PA Primary

Addresses

Primary practice location

120 Aliso Dr SE Ste G
Albuquerque, NM 87108-2693

Mailing address

10700 Academy Rd NE Apt 2623
Albuquerque, NM 87111-7340
Phone (412) 716-3139

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20240806001078 NM Practitioner - Clinical Social Worker 8820346489 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW018371PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Enchanting Skies Healing LLC CurrentSince May 26, 2024 Accepting new patients
Phases of You, LLC Clinical Current Accepting new patients

Locations

120 Aliso Dr SE
Ste G
Albuquerque, NM 87108
Phone (412) 423-8227

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1275609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1265752950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 ACADEMY RD NE APT 2623",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871117340",
            "telephone_number": "412-716-3139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 ALISO DR SE STE G",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871082693",
            "telephone_number": "412-423-8227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHM",
        "first_name": "DIANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-04",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW018371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.