Diane Witzel, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801104194 Issued in MI

Practice address

800 E Milham Ave Ste 200
Portage, MI 49002

Phone

(269) 249-7179

Fax

(269) 459-7149

NPI assigned

May 15, 2019

Last updated

Feb 2, 2023By the provider in NPPES

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

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": "1557878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1952967853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 N SAGE ST APT 11",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490064061",
            "telephone_number": "269-697-3317",
            "fax_number": "269-697-3317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E MILHAM AVE STE 200",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "49002",
            "telephone_number": "269-249-7179",
            "fax_number": "269-459-7149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITZEL",
        "first_name": "DIANE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-15",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801104194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Portage, MI
• Providers in Portage, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; 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.