Active NPI
Candida Rosa Diaz, LCSW-R
- Contractor
- Yonkers, NY
National Provider Identifier
1023261583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- R058985
- Practice address
- 289 Sommerville PL
Yonkers, NY 10703-2212 - Phone
- (914) 969-0186
- NPI assigned
- Oct 28, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | R058985 | NY | Primary |
Addresses
Primary practice location
289 Sommerville PL
Yonkers, NY 10703-2212
Mailing address
289 Sommerville PL
Yonkers, NY 10703-2212
Phone (914) 969-0186
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101214000002 | NY | Practitioner - Clinical Social Worker | 9931396140 | Practice locations: Scarsdale, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Face to Face Counseling and Psychotherapy | Past | 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
- Scarsdale, NY
- NPI 1568883130
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225152000000",
"number": "1023261583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "289 SOMMERVILLE PL",
"city": "YONKERS",
"state": "NY",
"postal_code": "107032212",
"telephone_number": "914-969-0186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "289 SOMMERVILLE PL",
"city": "YONKERS",
"state": "NY",
"postal_code": "107032212",
"telephone_number": "914-969-0186"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "CANDIDA",
"middle_name": "ROSA",
"name_prefix": "Mrs.",
"credential": "LCSW-R",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-10-28",
"last_updated": "2008-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "NY",
"license": "R058985",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yonkers, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.