Individual provider Active NPI

Tami Graven Dietz, LCSA

  • Social Worker
  • Charlotte, NC
National Provider Identifier
1295396695
Registry record updated Jun 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
C007510 Issued in NC
Practice address
9719 Aragorn LN NW
Charlotte, NC 28269-6998
Phone
(704) 807-7545
NPI assigned
Jun 26, 2019
Last updated
Jun 26, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X C007510 NC Primary

Addresses

Primary practice location

9719 Aragorn LN NW
Charlotte, NC 28269-6998

Mailing address

9719 Aragorn LN NW
Charlotte, NC 28269-6998
Phone (704) 807-7545

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
C007510NCMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1561507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1295396695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9719 ARAGORN LN NW",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282696998",
            "telephone_number": "704-807-7545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9719 ARAGORN LN NW",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282696998",
            "telephone_number": "704-807-7545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETZ",
        "first_name": "TAMI",
        "middle_name": "GRAVEN",
        "credential": "LCSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-26",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NC",
            "license": "C007510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2019; 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.