Individual provider Active NPI

Diane M Bittle, MSW.,LCSW

  • Clinical Social Worker
  • Peoria, IL
National Provider Identifier
1710957550
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
5016 N University St
Suite 105
Peoria, IL 61614-4781
Phone
(309) 692-7779
Fax
(309) 692-7779
NPI assigned
Jan 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

5016 N University St
Suite 105
Peoria, IL 61614-4781

Mailing address

5016 N University St
Suite 105
Peoria, IL 61614-4781
Phone (309) 692-7779

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20090209000353 IL Practitioner - Clinical Social Worker 6103981170 Practice locations: Peoria, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5113 N Executive Dr
Suite 103
Peoria, IL 61614-4884

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149-000549ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cambron Talbott Counseling Clinical Past Accepting new patients

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": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1710957550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5016 N UNIVERSITY ST",
            "address_2": "SUITE 105",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144781",
            "telephone_number": "309-692-7779",
            "fax_number": "309-692-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5016 N UNIVERSITY ST",
            "address_2": "SUITE 105",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144781",
            "telephone_number": "309-692-7779",
            "fax_number": "309-692-7779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BITTLE",
        "first_name": "DIANE",
        "middle_name": "M",
        "credential": "MSW.,LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-24",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.