Individual provider Active NPI

Diane Carol Stowe, LCSW

  • Clinical Social Worker
  • Lansdowne, PA
National Provider Identifier
1013959543
Registry record updated Jul 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW 3011 L Issued in PA
Practice address
60 S Lansdowne Ave
Lansdowne, PA 19050-2343
Phone
(267) 253-8308
Fax
(610) 626-1264
NPI assigned
Jun 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2016

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 CW 3011 L PA Primary

Addresses

Primary practice location

60 S Lansdowne Ave
Lansdowne, PA 19050-2343

Mailing address

121 N Oak Ave
Clifton Heights, PA 19018-1426
Phone (267) 253-8308

Other identifiers 1

IdentifierTypeStateIssuer
0019497580001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20060727000251 PA Practitioner - Clinical Social Worker 2668485269 Practice locations: Lansdowne, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

60 S Lansdowne Ave
Lansdowne, PA 19050-2343
Phone (267) 253-8308

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW 3011 LPAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467331200000",
    "number": "1013959543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 N OAK AVE",
            "city": "CLIFTON HEIGHTS",
            "state": "PA",
            "postal_code": "190181426",
            "telephone_number": "267-253-8308",
            "fax_number": "610-259-0562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 S LANSDOWNE AVE",
            "city": "LANSDOWNE",
            "state": "PA",
            "postal_code": "190502343",
            "telephone_number": "267-253-8308",
            "fax_number": "610-626-1264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOWE",
        "first_name": "DIANE",
        "middle_name": "CAROL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-11",
        "last_updated": "2016-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW 3011 L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019497580001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansdowne, PA

Sources for this page

Verify at the official NPI Registry.