Individual provider Active NPI

Diana Koulikova, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1053736256
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
094719 Issued in NY
Practice address
2502 86TH St FL 3
Brooklyn, NY 11214-4440
Phone
(347) 391-4250
NPI assigned
Feb 25, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2026

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 094719 NY Primary

Addresses

Primary practice location

2502 86TH St FL 3
Brooklyn, NY 11214-4440

Mailing address

1855 E 12TH St Apt 3N
Brooklyn, NY 11229-2775
Phone (718) 312-2923

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230302001641 NY Practitioner - Clinical Social Worker 0042683583 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interborough Developmental and Consultation Center IncGroup PAC ID 7911898192, 167 clinicians

Practice addresses (Care Compare)

1623 Kings Hwy
Brooklyn, NY 11229-1209
Phone 9292737601426

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
094719NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Interborough Developmental and Consultation Center, Inc. Social Worker CurrentSince Jan 5, 2023 Accepting new patients
Interborough Developmental and Consultation Center, Inc. CurrentSince Jan 5, 2023 Accepting new patients

Locations

1623 Kings Hwy
Brooklyn, NY 11229
Phone (718) 307-6800

Organizations & group practices 3

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": "1393286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1053736256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 E 12TH ST APT 3N",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112292775",
            "telephone_number": "718-312-2923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2502 86TH ST FL 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112144440",
            "telephone_number": "347-391-4250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOULIKOVA",
        "first_name": "DIANA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-25",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "094719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.