Active NPI
Diane Dalene Denice Kline-Gorney, LBSW
- Social Worker
- West Branch, MI
National Provider Identifier
1912201112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6802077949
- Practice address
- 511 Griffin Rd
West Branch, MI 48661-9251 - Phone
- (989) 345-5571
- Fax
- (989) 345-4111
- NPI assigned
- Jan 3, 2011
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 6802077949 | MI | Primary |
Addresses
Primary practice location
511 Griffin Rd
West Branch, MI 48661-9251
Mailing address
PO Box 310
Tawas City, MI 48764-0310
Phone (989) 362-8636
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 |
|---|---|---|---|
| 6802077949 | MI | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ausable Valley Community Mental Health Services Board | Past | Accepting new patients | |
| Ausable Valley CMH | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Clinic/Center
- Tawas City, MI
- NPI 1952628893
-
- Community/Behavioral Health Agency
- Tawas City, MI
- NPI 1417011701
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294012800000",
"number": "1912201112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 310",
"city": "TAWAS CITY",
"state": "MI",
"postal_code": "487640310",
"telephone_number": "989-362-8636",
"fax_number": "989-362-7800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "511 GRIFFIN RD",
"city": "WEST BRANCH",
"state": "MI",
"postal_code": "486619251",
"telephone_number": "989-345-5571",
"fax_number": "989-345-4111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLINE-GORNEY",
"first_name": "DIANE",
"middle_name": "DALENE DENICE",
"credential": "LBSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-03",
"last_updated": "2011-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6802077949",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Branch, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.