Dianne Elizabeth Daugherty, ACSW, LCSW
Individual provider Active NPI Clinical Social Worker · Kendallville, IN
NPI 1962673111 · NPPES record last updated Mar 17, 2008
Key facts
- NPI
- 1962673111
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 34002012A (IN)
- Practice address
- 220 S Main St
Kendallville, IN 46755-1718 - Phone
- (260) 347-2453
- Fax
- (260) 347-5649
- NPI assigned
- Mar 17, 2008
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34002012A | IN | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 34002012A | IN | Yes |
Addresses
Primary practice location
220 S Main St
Kendallville, IN 46755-1718
Mailing address
220 S Main St
PO Box 817
Kendallville, IN 46755-1718
Phone (260) 347-2453
Other providers in Kendallville, IN
- Connie S Carunchia Professional Corporation
- Patrick John Connolly
- Kaitlin Beth Cowan
- Michael Thomas Cox
- Joseph F Csincsak
- David R. Sofair, PC
- Amanda Day
- Theodore L Deal Jr.
- Stephanie Michelle Debolt
- Jason D Dedoes
All providers in Kendallville, IN · Clinical Social Worker in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.