Diem Thi Kim Hong Cao, LICSW, LADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

21938 Issued in MN

Practice address

2785 White Bear Ave N
Suit 403
Maplewood, MN 55109-1307

Phone

(651) 454-0114

Fax

(651) 454-3492

NPI assigned

Mar 7, 2016

Last updated

Mar 7, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grand Rapids Counseling ServicesGroup PAC ID 0547794000, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Grand Rapids Counseling Services

  • Professional Counselor
  • Grand Rapids, MI
  • NPI 1629597166

  Addiction (Substance Use Disorder)

  Medicare reassignment Care Compare group NPD
• Carpe Christum Counseling LLC

  • Clinical Social Worker
  • Kenwood, MI
  • NPI 1750019881
  NPD Authorized official

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

{
    "created_epoch": "1457308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457308800000",
    "number": "1376903187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 OLEARY LN",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551232340",
            "telephone_number": "651-454-0114",
            "fax_number": "651-454-3492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2785 WHITE BEAR AVE N",
            "address_2": "SUIT 403",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091307",
            "telephone_number": "651-454-0114",
            "fax_number": "651-454-3492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAO",
        "first_name": "DIEM",
        "middle_name": "THI KIM HONG",
        "credential": "LICSW, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-07",
        "last_updated": "2016-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "304113",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "21938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin Hemmerich, DDS, PA (Ridge Periodontics & Dental Implants)
• Stephanie F Callanan, MD
• Donald Wayne Calvin, O.D.
• Camel Transportation L. L. C.
• Joseph D Canto, MD
• Care Ride Transportation Inc
• Care Special Transportation, LLC
• Gina Carlson
• Hope Michelle Carlson, LADC
• Emily A Carver, MD

• Clinical Social Worker in Maplewood, MN
• Providers in Maplewood, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.