NPIMap

Organization Active NPI

Jeanette Diederich

  • Clinical Social Worker
  • Wichita, KS
National Provider Identifier
1376813246
Registry record updated Jan 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3926 Issued in KS
Legal business name
JEANETTE DIEDERICH
Practice address
520 S Holland St
Suite 401
Wichita, KS 67209-2096
Phone
(316) 729-9965
Fax
(316) 854-0950
NPI assigned
Jan 9, 2012
Last updated
Jan 9, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2012

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

Authorized official

Name
Ms. Jeanette Kathleen Diederich, LSCSW
Title
Therapist
Phone
(316) 729-9965

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 3926 KS Primary

Addresses

Primary practice location

520 S Holland St
Suite 401
Wichita, KS 67209-2096

Mailing address

520 S Holland St
Suite 401
Wichita, KS 67209-2096
Phone (316) 729-9965

Other names 1

  • Jeanette Schiffelbein Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1326067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326067200000",
    "number": "1376813246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 S HOLLAND ST",
            "address_2": "SUITE 401",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672092096",
            "telephone_number": "316-729-9965",
            "fax_number": "316-854-0950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S HOLLAND ST",
            "address_2": "SUITE 401",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672092096",
            "telephone_number": "316-729-9965",
            "fax_number": "316-854-0950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEANETTE DIEDERICH",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-09",
        "last_updated": "2012-01-09",
        "status": "A",
        "authorized_official_last_name": "DIEDERICH",
        "authorized_official_first_name": "JEANETTE",
        "authorized_official_middle_name": "KATHLEEN",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "316-729-9965",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LSCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "3926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jeanette Schiffelbein",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2012; 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.