Individual provider Active NPI

Diane Leslie Channas, LCSW-C

  • Clinical Social Worker
  • Annapolis, MD
National Provider Identifier
1568476869
Registry record updated Aug 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
06322 Issued in MD
Practice address
108 Old Solomons Island Rd
Suite U-7
Annapolis, MD 21401-3845
Phone
(410) 266-8345
Fax
(410) 266-6278
NPI assigned
Jul 29, 2006
Last updated
Aug 23, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 06322 MD Primary

Addresses

Primary practice location

108 Old Solomons Island Rd
Suite U-7
Annapolis, MD 21401-3845

Mailing address

108 Old Solomons Island Rd
Suite U-7
Annapolis, MD 21401-3845
Phone (410) 266-8345

Other identifiers 1

IdentifierTypeStateIssuer
2866021 00MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20101011000363 MD Practitioner - Clinical Social Worker 1052503919 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Maryland School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arundel Mental Health Professionals LCGroup PAC ID 4981688173, 118 clinicians

Practice addresses (Care Compare)

1662 Village GRN
Crofton, MD 21114-2014
Phone (410) 757-2077

8258 Veterans Hwy
Suite 13
Millersville, MD 21108-1564
Phone (410) 768-6088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06233MDMDCommunity Health Worker
06322MDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Arundel Mental Health Professionals L.C. CurrentSince Jul 18, 2022 Accepting new patients

Locations

1662 Village Grn
Crofton, MD 21114
Phone 4107572077 ext. 8137

1662 Village Grn
#B
Crofton, MD 21114

8258 Veterans Hwy
Ste 13
Millersville, MD 21108
Phone (410) 768-6088

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": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314057600000",
    "number": "1568476869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 OLD SOLOMONS ISLAND RD",
            "address_2": "SUITE U-7",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013845",
            "telephone_number": "410-266-8345",
            "fax_number": "410-266-6278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 OLD SOLOMONS ISLAND RD",
            "address_2": "SUITE U-7",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013845",
            "telephone_number": "410-266-8345",
            "fax_number": "410-266-6278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANNAS",
        "first_name": "DIANE",
        "middle_name": "LESLIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-29",
        "last_updated": "2011-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "06322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2866021 00",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.