Active NPI
Diane Ice, MSW
- Social Worker
- Evansville, IN
National Provider Identifier
1962037655
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 33005841A
- Practice address
- 315 Mulberry St
Evansville, IN 47713-1252 - Phone
- (812) 421-7489
- Fax
- (812) 436-0209
- NPI assigned
- Mar 3, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | 33005841A | IN | Primary |
Addresses
Primary practice location
315 Mulberry St
Evansville, IN 47713-1252
Mailing address
315 Mulberry St
Evansville, IN 47713-1252
Phone (812) 421-7489
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 |
|---|---|---|---|
| 33005841A | IN | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583193600000",
"number": "1962037655",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "315 MULBERRY ST",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477131252",
"telephone_number": "812-421-7489",
"fax_number": "812-436-0209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 MULBERRY ST",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477131252",
"telephone_number": "812-421-7489",
"fax_number": "812-436-0209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ICE",
"first_name": "DIANE",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-03-03",
"last_updated": "2020-03-03",
"certification_date": "2020-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker",
"state": "IN",
"license": "33005841A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evansville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.