Individual provider Active NPI

Diane Conn

  • Clinical Social Worker
  • Columbus, OH
National Provider Identifier
1679737407
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I0008676 Issued in OH
Practice address
81 Outerbelt St
Columbus, OH 43213-1548
Phone
(614) 759-5075
Fax
(614) 759-5079
NPI assigned
Jul 10, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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 I0008676 OH Primary

Addresses

Primary practice location

81 Outerbelt St
Columbus, OH 43213-1548

Mailing address

81 Outerbelt St
Columbus, OH 43213-1548
Phone (614) 759-5075

Other names 1

  • Diane Conn Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20090428000073 OH Practitioner - Clinical Social Worker 0941367973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psychological and Behavioral Consultants LLCGroup PAC ID 0446243760, 595 clinicians

Practice addresses (Care Compare)

150 Taylor Station Rd
Suite 310
Columbus, OH 43213-1157
Phone (614) 986-2790

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I0008676OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological & Behavioral Consultants, LLC Clinical CurrentSince Oct 27, 2020 Accepting new patients

Locations

25101 Chagrin Blvd
Ste 100
Beachwood, OH 44122
Phone (216) 245-4468

81 Outerbelt St
Columbus, OH 43213
Phone (614) 759-5075

150 Taylor Station Rd
Ste 310
Columbus, OH 43213
Phone (614) 986-2790

25111 Country Club Blvd
Ste 290
North Olmsted, OH 44070
Phone (440) 614-2520

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1679737407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 OUTERBELT ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432131548",
            "telephone_number": "614-759-5075",
            "fax_number": "614-759-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 OUTERBELT ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432131548",
            "telephone_number": "614-759-5075",
            "fax_number": "614-759-5079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONN",
        "first_name": "DIANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-10",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0008676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "CONN",
            "credential": "LISW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.