Bridget Dietz, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149024574 Issued in IL

Practice address

4707 N Broadway St Ste 200
Chicago, IL 60640-4999

Phone

(312) 971-9441

NPI assigned

Dec 13, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Psyche Wellbeing

  • Child & Adolescent Psychiatry Physician
  • Vancouver, WA
  • NPI 1609601384

  IL

  Medicare reassignment NPD
• Outspoken Therapy PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
  • NPI 1063247112
  NPD Authorized official
• Balance & Wellbeing, LLC

  • Child & Adolescent Psychiatry Physician
  • Schaumburg, IL
  • NPI 1386299675
  Medicare reassignment
• Cornerstones of Care

  • Mental Illness Community Based Residential Treatment Facility
  • Kansas City, MO
  • NPI 1720447212

  Social Worker

  NPD (past)
• Gillis Center, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Kansas City, MO
  • NPI 1881664365
  NPD (past)

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

{
    "created_epoch": "1481587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1720522592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4707 N BROADWAY ST STE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404999",
            "telephone_number": "312-971-9441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4707 N BROADWAY ST STE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404999",
            "telephone_number": "312-971-9441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETZ",
        "first_name": "BRIDGET",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-13",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "05707",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "10209",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "2016041300",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149024574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ariana Dietrich
• Hannah Lane Dietrich, APRN
• Jonathan Jacob Dietrich, MD
• Kelly Dietrick
• Nancy Ann Diettrich, MD
• Deidre Anne Dietz, M.D.
• Hannah R Dietz
• James Dietz, LPC
• Anton N Dietzen, M.D., D.C.
• Richard J Dietzen, DC

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.