Active NPI
Diana K Moryl, LCSW
- Clinical Social Worker
- Granger, IN
National Provider Identifier
1295361863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34001715A
- Practice address
- 6910 N Main St Unit 13L
Granger, IN 46530-9681 - Phone
- (574) 231-6766
- Fax
- (833) 249-2411
- NPI assigned
- Mar 16, 2020
- Last updated
- Mar 16, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 34001715A | IN | Primary |
Addresses
Primary practice location
6910 N Main St Unit 13L
Granger, IN 46530-9681
Mailing address
6910 N Main St
Ste 13L, Box 52
Granger, IN 46530
Phone (574) 231-6766
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NONE | Other | NONE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | glbms.com | Other |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34001715A | IN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584316800000",
"number": "1295361863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6910 N MAIN ST",
"address_2": "STE 13L, BOX 52",
"city": "GRANGER",
"state": "IN",
"postal_code": "46530",
"telephone_number": "574-231-6766",
"fax_number": "833-249-2411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6910 N MAIN ST UNIT 13L",
"city": "GRANGER",
"state": "IN",
"postal_code": "465309681",
"telephone_number": "574-231-6766",
"fax_number": "833-249-2411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORYL",
"first_name": "DIANA",
"middle_name": "K",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-03-16",
"last_updated": "2020-03-16",
"certification_date": "2020-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34001715A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NONE",
"identifier": "NONE",
"state": null
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "glbms.com",
"affiliation": "N",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "website",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "text",
"address_1": "6910 N Main St Unit 13L",
"city": "Granger",
"state": "IN",
"country_code": "US",
"postal_code": "465309681",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Granger, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.