Individual provider Active NPI

Luz del Alba Reynoso, LCSW

  • Clinical Social Worker
  • Newark, DE
National Provider Identifier
1003104902
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
Q1-0001009 Issued in DE
Practice address
179 W Chestnut Hill Rd Ste 6
Newark, DE 19713-2210
Phone
(302) 358-6237
Fax
(888) 358-6570
NPI assigned
Jul 13, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Q1-0001009 DE Primary

Addresses

Primary practice location

179 W Chestnut Hill Rd Ste 6
Newark, DE 19713-2210

Mailing address

179 W. Chestnut Hill Rd
Suite 6
Newark, DE 19713
Phone (302) 358-6237

Other practice location 1

12 Birchgrove Rd
Newark, DE 19702-3749
Phone (302) 369-0748

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)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Embrace the Change Counseling Clinical CurrentSince Jul 24, 2022 Accepting new patients
Embrace the Change Counseling Clinical CurrentSince Jul 24, 2022 Accepting new patients

Locations

179 W Chestnut Hill Rd
Ste 6
Newark, DE 19713
Phone (302) 358-6237

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1310515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1003104902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 W. CHESTNUT HILL RD",
            "address_2": "SUITE 6",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "19713",
            "telephone_number": "302-358-6237",
            "fax_number": "888-358-6570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 W CHESTNUT HILL RD STE 6",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132210",
            "telephone_number": "302-358-6237",
            "fax_number": "888-358-6570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 Birchgrove Rd",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197023749",
            "country_code": "US",
            "telephone_number": "302-369-0748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOSO",
        "first_name": "LUZ DEL ALBA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-13",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DE",
            "license": "Q1-0001009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.