NPIMap

Organization Active NPI

Diana L Theiss PHD

Doing business as Sylvania Therapy and Counseling

  • Clinical Social Worker
  • Sylvania, OH
National Provider Identifier
1396250338
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I0900183-SUPV Issued in OH
Legal business name
DIANA L THEISS PHD
Doing business as
Sylvania Therapy and Counseling
Practice address
5800 Monroe St Ste A1
Sylvania, OH 43560-2208
Phone
(419) 517-7073
Fax
(419) 517-0122
NPI assigned
Dec 13, 2017
Last updated
Mar 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

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

Authorized official

Name
Diana L Theiss, PHD LISWNPI 1265722813
Title
Practice Owner
Phone
(419) 843-5945

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I0900183-SUPV OH Primary

Addresses

Primary practice location

5800 Monroe St Ste A1
Sylvania, OH 43560-2208

Mailing address

5800 Monroe St Ste A1
Sylvania, OH 43560-2208
Phone (419) 517-7073

Other identifiers 1

IdentifierTypeStateIssuer
0155198MedicaidOH

Other names 1

  • Sylvania Therapy and Counseling Doing business as

National Provider Directory

National Provider Directory

Locations

5800 Monroe St
Ste A1
Sylvania, OH 43560
Phone (419) 276-3556

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1513123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677715200000",
    "number": "1396250338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 MONROE ST STE A1",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602208",
            "telephone_number": "419-517-7073",
            "fax_number": "419-517-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 MONROE ST STE A1",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602208",
            "telephone_number": "419-517-7073",
            "fax_number": "419-517-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIANA L THEISS PHD",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-13",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A",
        "authorized_official_last_name": "THEISS",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "419-843-5945",
        "authorized_official_credential": "PHD LISW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0900183-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0155198",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sylvania Therapy and Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sylvania, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; 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.