Individual provider Active NPI

Diane M. Blumenthal, MSW, LCSW

  • Clinical Social Worker
  • Arlington Heights, IL
National Provider Identifier
1629117007
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
3285 N Arlington Heights Rd
Suite 203
Arlington Heights, IL 60004-1564
Phone
(847) 392-4445
Fax
(847) 368-1301
NPI assigned
Feb 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

3285 N Arlington Heights Rd
Suite 203
Arlington Heights, IL 60004-1564

Mailing address

3285 N Arlington Heights Rd
Suite 203
Arlington Heights, IL 60004-1564
Phone (847) 392-4445

Other names 1

  • Mrs. Diane M. Wade - Blumenthal Former name

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
149.004100ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629117007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3285 N ARLINGTON HEIGHTS RD",
            "address_2": "SUITE 203",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600041564",
            "telephone_number": "847-392-4445",
            "fax_number": "847-368-1301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3285 N ARLINGTON HEIGHTS RD",
            "address_2": "SUITE 203",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600041564",
            "telephone_number": "847-392-4445",
            "fax_number": "847-368-1301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUMENTHAL",
        "first_name": "DIANE",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "WADE - BLUMENTHAL",
            "middle_name": "M.",
            "prefix": "MRS.",
            "credential": "MSW, LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Arlington Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.