Mitzi Audra Diesing in Jackson - Clinical
Mitzi Audra Diesing - NPI 1073568374
Mitzi Audra Diesing is a Clinical in Jackson, Michigan. Mitzi Audra Diesing practices all healthcare services and medical treatments related to Clinical. The NPI Number for Mitzi Audra Diesing is 1073568374. The last update date is 2021-10-20.
Mitzi Audra Diesing's current location address is 1200 N. West Ave., Jackson, Michigan. You can contact this provider via phone number 5173003985 and fax number 5178161267. The mailing address for Mitzi Audra Diesing is 1200 N. West Ave., Jackson, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mitzi Audra Diesing |
|---|---|
| Address | 1200 N. West Ave., Jackson, Michigan |
| Phone Number | 5173003985 |
| Fax Number | 5178161267 |
| Sole Proprietor | N |
| Credentials | MSW, LMSW |
NPI Number Detail
| NPI Number | 1073568374 |
|---|---|
| Provider Enumeration Date | 2006-05-24 |
| Last Updated Date | 2021-10-20 |
Provider Mailing Address Detail
| Address | 1200 N. West Ave. |
|---|---|
| City | Jackson |
| State | Michigan (MI) |
| Post Code | 492022179 |
| Phone Number | 5173003985 |
| Fax Number | 5178161267 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 6801083573 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 718982000 | MI | MAGELLAN STATE OF MI | |
| 8008970860 | MI | TRADITIONAL BCBS |
Post Comment/ Review Below
What is the Mitzi Audra Diesing's unique identification number?
The Mitzi Audra Diesing has been assigned the NPI (National Provider Identifier) Number 1073568374 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Can you provide the Mitzi Audra Diesing's physical address?
The Mitzi Audra Diesing is physically located at 1200 N. West Ave., in the city of Jackson, MI, with the postal code 492022179.
What is the area of specialization for Mitzi Audra Diesing, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Mitzi Audra Diesing is Clinical, and the corresponding taxonomy code that categorizes this area of expertise is 1041C0700X.
When did Mitzi Audra Diesing receive its 1073568374 assignment?
The Mitzi Audra Diesing was assigned its 1073568374 on 2006-05-24, which is the date when this unique identifier was issued to the organization.
When was the information regarding Mitzi Audra Diesing most recently updated?
The details pertaining to the Mitzi Audra Diesing, including its address, specialty, and other relevant information, were last refreshed on 2021-10-20.