Individual provider Active NPI

Anna Marie Dietz Henk, LSCSW

  • Clinical Social Worker
  • Olathe, KS
National Provider Identifier
1427120120
Registry record updated Mar 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
KS2317 Issued in KS
Practice address
12240 S Mullen Rd
Olathe, KS 66062-1493
Phone
(913) 385-9448
NPI assigned
Nov 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X KS2317 KS Primary
Clinical Social Worker 1041C0700X MO2002019553 MO

Addresses

Primary practice location

12240 S Mullen Rd
Olathe, KS 66062-1493

Mailing address

12240 S Mullen Rd
Olathe, KS 66062-1493
Phone (913) 385-9448

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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

Enrollment IDStateProvider typePAC IDDetails
I20110519000397 KS Practitioner - Clinical Social Worker 7911183397 Practice locations: Olathe, KS

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11695 S Blackbob Rd
Olathe, KS 66062-1058
Phone (913) 522-5696

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2317KSMDClinical Child & Adolescent Psychologist
KS2317KSMDClinical Social Worker
MO2002019553MOMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301529600000",
    "number": "1427120120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12240 S MULLEN RD",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660621493",
            "telephone_number": "913-385-9448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12240 S MULLEN RD",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660621493",
            "telephone_number": "913-385-9448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETZ HENK",
        "first_name": "ANNA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LSCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2011-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "KS2317",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "MO2002019553",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olathe, KS

Sources for this page

Verify at the official NPI Registry.