Active NPI
Diana Osipsov, LMSW
- Clinical Social Worker
- Ionia, MI
National Provider Identifier
1992055974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 375 Apple Tree Dr
Ionia, MI 48846-7506 - Phone
- (616) 527-1790
- NPI assigned
- Sep 17, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6801094537 | MI | |
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
375 Apple Tree Dr
Ionia, MI 48846-7506
Mailing address
375 Apple Tree Dr
Ionia, MI 48846-7506
Phone (616) 527-1790
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 383274841 | Other | COMMERCIAL | |
| 1715928 | Medicaid | MI |
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 |
|---|---|---|---|
| 6801094537 | MI | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Roots Therapeutic Specialty Services | Clinical | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Social Worker
- Zeeland, MI
- NPI 1861023756
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417478400000",
"number": "1992055974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "375 APPLE TREE DR",
"city": "IONIA",
"state": "MI",
"postal_code": "488467506",
"telephone_number": "616-527-1790"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "375 APPLE TREE DR",
"city": "IONIA",
"state": "MI",
"postal_code": "488467506",
"telephone_number": "616-527-1790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OSIPSOV",
"first_name": "DIANA",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-17",
"last_updated": "2014-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801094537",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMERCIAL",
"identifier": "383274841",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1715928",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ionia, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.