Individual provider Active NPI

Victoria Dibiase

  • Clinical Social Worker
  • South Bend, IN
National Provider Identifier
1447857602
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34010381A Issued in IN
Practice address
PO Box 2373
South Bend, IN 46680-2373
Phone
(574) 318-0578
NPI assigned
Oct 1, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 13358-C NV
Counselor 101Y00000X
Clinical Social Worker 1041C0700X 119007 TX
Clinical Social Worker 1041C0700X 34010381A IN Primary

Addresses

Primary practice location

PO Box 2373
South Bend, IN 46680-2373

Mailing address

PO Box 2373
South Bend, IN 46680-2373
Phone (574) 318-0578

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20230518002664 IN Practitioner - Clinical Social Worker 6507222486 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brightside Health IncGroup PAC ID 9234525098, 213 clinicians

Practice addresses (Care Compare)

17 N 5TH Ave
Suite 1021
Beech Grove, IN 46107-1325
Phone (415) 360-3348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34010381AINMDClinical Social Worker
119007TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bowen Health Inc CurrentSince Apr 18, 2023 Accepting new patients
Brightside Health, Inc. CurrentSince Sep 1, 2024 Accepting new patients
Bowen Health Inc CurrentSince Apr 18, 2023 Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

17 N 5th Ave
#1021
Beech Grove, IN 46107

990 Illinois St
Plymouth, IN 46563
Phone (574) 936-9646

2621 E Jefferson St
Warsaw, IN 46580
Phone (574) 269-0573

850 N Harrison St
Warsaw, IN 46580
Phone (219) 267-7169

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1601510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1447857602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2373",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466802373",
            "telephone_number": "574-318-0578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 2373",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466802373",
            "telephone_number": "574-318-0578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBIASE",
        "first_name": "VICTORIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-01",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "13358-C",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "119007",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34010381A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.