Individual provider Active NPI

Amber Diguiseppi, LCSW

  • Clinical Social Worker
  • Rockford, IL
National Provider Identifier
1528355757
Registry record updated Jun 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.015574 Issued in IL
Practice address
1222 E State St
Rockford, IL 61104-2230
Phone
(815) 965-3455
Fax
(815) 965-3673
NPI assigned
Jul 8, 2011
Last updated
Jun 4, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150.013099 IL
Clinical Social Worker 1041C0700X 149.015574 IL Primary

Addresses

Primary practice location

1222 E State St
Rockford, IL 61104-2230

Mailing address

1222 E State St
Rockford, IL 61104-2230
Phone (815) 965-3455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
150.013099ILMDSocial Worker
149.015574ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Arc of Winnebago, Boone and Ogle Counties Past Accepting new patients

Organizations & group practices 1

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": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370304000000",
    "number": "1528355757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611042230",
            "telephone_number": "815-965-3455",
            "fax_number": "815-965-3673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611042230",
            "telephone_number": "815-965-3455",
            "fax_number": "815-965-3673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIGUISEPPI",
        "first_name": "AMBER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-08",
        "last_updated": "2013-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.013099",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.015574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2013; 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.