Maritza Rodriguez Diaz, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

309 W Clark St
Champaign, IL 61820-4637

Phone

(217) 398-9066

NPI assigned

Nov 12, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Maritza Rodriguez Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1636675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1801552930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 W CLARK ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618204637",
            "telephone_number": "217-398-9066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 W CLARK ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618204637",
            "telephone_number": "217-398-9066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "MARITZA",
        "middle_name": "RODRIGUEZ",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-12",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARITZA",
            "last_name": "RODRIGUEZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alexis Deuel, RBT
• Bryan Michael Deutsch
• Developmental Foundations, Inc.
• Developmental Services Center
• Kathryn L. Dhom, P.T.A.
• Saron Dibissa
• Brooke Didomenico
• Samira Grace Didos, PH.D.
• Katherine Difanis
• Ma R Difanis, NP

• Clinical Social Worker in Champaign, IL
• Providers in Champaign, 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 Mar 10, 2022; 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.