Active NPI
Diane Lois Koranda, LICSW
- Clinical Social Worker
- Duluth, MN
National Provider Identifier
1700078805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 8565
- Practice address
- 320 W 2ND St
RM 510
Duluth, MN 55802-1404 - Phone
- (218) 726-2995
- Fax
- (218) 725-5186
- NPI assigned
- Aug 13, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 8565 | MN | Primary |
Addresses
Primary practice location
320 W 2ND St
RM 510
Duluth, MN 55802-1404
Mailing address
320 W 2ND St
RM 510
Duluth, MN 55802-1404
Phone (218) 726-2995
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
| License | State | Type | Specialty |
|---|---|---|---|
| 8565 | MN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186963200000",
"number": "1700078805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 W 2ND ST",
"address_2": "RM 510",
"city": "DULUTH",
"state": "MN",
"postal_code": "558021404",
"telephone_number": "218-726-2995",
"fax_number": "218-725-5186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 W 2ND ST",
"address_2": "RM 510",
"city": "DULUTH",
"state": "MN",
"postal_code": "558021404",
"telephone_number": "218-726-2995",
"fax_number": "218-725-5186"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KORANDA",
"first_name": "DIANE",
"middle_name": "LOIS",
"name_prefix": "Mrs.",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-13",
"last_updated": "2007-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "8565",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Duluth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.