Diane Sue Mangold, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

06199 Issued in IA

Practice address

824 Flindt Dr
Suite 103
Storm Lake, IA 50588-3208

Phone

(712) 732-3736

Fax

(712) 732-3275

NPI assigned

May 8, 2006

Last updated

Jul 21, 2008By 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

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kanza Mental Health and Guidance Center, Inc.Group PAC ID 7810958998, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kanza Mental Health and Guidance Center, Inc.

  • Social Worker
  • Hiawatha, KS
  • NPI 1619909181
  Medicare reassignment Care Compare group NPD
• Pawnee Mental Health Service, Inc.

  • Primary Care Clinic/Center
  • Manhattan, KS
  • NPI 1356139158
  NPD (past)

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216598400000",
    "number": "1972552917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E 11TH ST",
            "city": "SPENCER",
            "state": "IA",
            "postal_code": "513014436",
            "telephone_number": "712-262-2922",
            "fax_number": "712-262-3826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 FLINDT DR",
            "address_2": "SUITE 103",
            "city": "STORM LAKE",
            "state": "IA",
            "postal_code": "505883208",
            "telephone_number": "712-732-3736",
            "fax_number": "712-732-3275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGOLD",
        "first_name": "DIANE",
        "middle_name": "SUE",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2008-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "06199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jodi L Lovell, PT
• Marilyn Kathleen Loy, OT
• Blake William Luy
• Alexandra Lyons, DPT
• Madison County Medical Equipment Inc (Jackson Medical Supply)
• Marathon Health, LLC
• Rick Alan Martin, DDS
• Sabrina Marie Martinez, MD
• Timothy Todd Masters, OD
• Linda Lou McClintock, ARNP

• Clinical Social Worker in Storm Lake, IA
• Providers in Storm Lake, IA by specialty
• Clinical Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.