Matthew Dimond, LICSW-A, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SC60968802 Issued in WA

Practice address

119 Pelly Ave N
Renton, WA 98057-5714

Phone

(206) 899-9940

NPI assigned

Jan 12, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1515715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561939200000",
    "number": "1831607787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 PELLY AVE N",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980575714",
            "telephone_number": "206-899-9940",
            "fax_number": "206-899-9940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 PELLY AVE N",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980575714",
            "telephone_number": "206-899-9940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "207 Main Ave S Apt 606",
            "address_purpose": "LOCATION",
            "city": "Renton",
            "state": "WA",
            "postal_code": "980575002",
            "country_code": "US",
            "telephone_number": "801-814-3106",
            "fax_number": "801-814-3106",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "502 Rainier Ave S",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981442085",
            "country_code": "US",
            "telephone_number": "541-858-8170",
            "fax_number": "541-858-8167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIMOND",
        "first_name": "MATTHEW",
        "credential": "LICSW-A, MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-12",
        "last_updated": "2019-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "UT",
            "license": "10382599-3502",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC60968802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Diehl, RN, MSN, FNP-C
• Chelsea E Diers, ARNP
• Celeste Dillard, RN00129734
• Joanne Kay Dilley, LMP
• Leah Dimino
• Sarah C Dinkel, SLP
• Josephine Janine Dion, MS, CCC-SLP
• Megan Aileen Dippe, PA-C
• Christopher A Dire, MD
• Sundus Dirie

• Clinical Social Worker in Renton, WA
• Providers in Renton, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2019; 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.