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DIANE BRACAMONTES LCSW
NPI 1306089974
Social Worker - Clinical in Maryville, IL

Active since April 13, 2009Opted out of Medicare · through May 10, 2028
2016 VADALABENE DR STE A, MARYVILLE, IL 62062(618) 823-6444(618) 551-8456 Get Directions Write a Review

NPPES record last updated: March 8, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Diane Bracamontes Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DIANE BRACAMONTES LCSW (NPI 1306089974) is an individual clinical provider in Maryville, Illinois, licensed in Illinois (149013539) and active in the NPI registry since April 2009. She has opted out of Medicare through May 10, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1306089974
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameDIANE BRACAMONTESCredential: LCSW
Location Address2016 VADALABENE DR STE AMaryville, IL 62062-6901
Mailing Address2016 Vadalabene Dr Ste AMaryville, IL 62062-6901 · (618) 823-6444 · Fax (618) 551-8456
Phone(618) 823-6444
Fax(618) 551-8456
Sole ProprietorYes
Enumeration DateApril 13, 2009
Last NPPES UpdateMarch 8, 2016
✔ NPI 1306089974 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in IL · 149013539
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, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
2016 VADALABENE DR STE A, Maryville, IL 62062
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Diane Bracamontes Lcsw has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from May 10, 2016 through May 10, 2028.

Opt-Out Effective DateMay 10, 2016
Opt-Out In Effect ThroughMay 10, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62062 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $56.28 – $173.35
Typical copayment $0.00 (range $14.07 – $43.33)
Most-billed visit code NA
Established Patient
$70.42 typical visit price
range $17.51 – $139.99
Typical copayment $17.60 (range $4.37 – $34.99)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANN LK MILLIKIN, LCPC
Counselor (Mental Health)
2016 VADALABENE DR STE A
MARYVILLE, IL 62062
Madison County (618) 604-1696
KATHERINE N REHG MA
Counselor (Professional)
2016 VADALABENE DR STE A
MARYVILLE, IL 62062
Madison County (618) 974-1263
PEACE OF MIND COUNSELING, LLC
Community/Behavioral Health
2016 VADALABENE DR STE A
MARYVILLE, IL 62062
Madison County (618) 823-6444
GRETCHEN A KOEHNE LCPC
Counselor (Professional)
2016 VADALABENE DR STE A
MARYVILLE, IL 62062
Madison County (618) 960-5750

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Diane Bracamontes's NPI number?

The NPI number for Diane Bracamontes is 1306089974. It was assigned to this individual provider in the NPPES registry on April 13, 2009.

Where is Diane Bracamontes located?

Diane Bracamontes practices at 2016 Vadalabene Dr Ste A, Maryville, IL 62062. The listed phone number is (618) 823-6444.

What is Diane Bracamontes's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Diane Bracamontes enrolled in Medicare?

No. Diane Bracamontes has opted out of Medicare through May 10, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Diane Bracamontes was last updated on March 8, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.