Individual provider Active NPI

Diane E Stiles, LCSW

  • Clinical Social Worker
  • Warsaw, IN
National Provider Identifier
1598871246
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34000990A Issued in IN
Practice address
3201 E Center Street Ext
Warsaw, IN 46582-3907
Phone
(574) 267-1700
Fax
(574) 267-0017
NPI assigned
Aug 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X 3400090A IN
Clinical Social Worker 1041C0700X 34000990A IN Primary

Addresses

Primary practice location

3201 E Center Street Ext
Warsaw, IN 46582-3907

Mailing address

3201 E Center Street Ext
Warsaw, IN 46582-3907
Phone (574) 267-1700

Other practice location 1

1500 North Ritter Avenue
Indianapolis, IN 46219-3027
Phone (317) 355-2560

Other identifiers 1

IdentifierTypeStateIssuer
100270530AMedicaidIN

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
I20200224000641 IN Practitioner - Clinical Social Worker 3274960794 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34000990AINMDClinical Social Worker
3400090AINMDSchool Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bowen Health Inc CurrentSince Feb 3, 2020 Accepting new patients
Bowen Health Inc CurrentSince Feb 3, 2020 Accepting new patients
McArthur Mental Health Services CurrentSince Jun 24, 2021 Accepting new patients

Locations

901 S Huntington St
Syracuse, IN 46567
Phone (574) 385-3144

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

3201 E Center Street Ext
Warsaw, IN 46582
Phone (574) 253-2220

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

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": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1598871246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 E CENTER STREET EXT",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465823907",
            "telephone_number": "574-267-1700",
            "fax_number": "574-267-0017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 E CENTER STREET EXT",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465823907",
            "telephone_number": "574-267-1700",
            "fax_number": "574-267-0017"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 North Ritter Avenue",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462193027",
            "country_code": "US",
            "telephone_number": "317-355-2560",
            "fax_number": "317-355-2418",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STILES",
        "first_name": "DIANE",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "IN",
            "license": "3400090A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34000990A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100270530A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warsaw, IN

Sources for this page

Verify at the official NPI Registry.