E Diane Thomas, MS, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

34002561A Issued in IN

Practice address

509 W Washington Blvd
Fort Wayne, IN 46802-2917

Phone

(260) 422-3034

Fax

(260) 422-3691

NPI assigned

Jul 18, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Clinical Social Worker

Education

Other, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Edt, Inc.Group PAC ID 7810176914, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Edt, Inc.

  • Mental Health Counselor
  • Fort Wayne, IN
  • NPI 1326111444
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1588682116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 W WASHINGTON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468022917",
            "telephone_number": "260-422-3034",
            "fax_number": "260-422-3691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 W WASHINGTON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468022917",
            "telephone_number": "260-422-3034",
            "fax_number": "260-422-3691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "E",
        "middle_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "MS, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "34002561A",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "35001087A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC-BS",
            "identifier": "000000183262",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angel Deshawn Thomas, FNP-BC
• Angela Thomas
• Bradley Thomas, PHARMD
• Carey Thomas, MSW, LSW
• Dustin M Thomas, MD
• Erin M. Thomas
• Evonne NA Thomas I, NURSE ASSISTANT
• Gabrial Thomas
• Gifty Mary Thomas
• Hannah Nicole Thomas

• Mental Health Counselor in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.