Active NPI
Diane E. Freedman, RLCSW
- Clinical Social Worker
- Smithtown, NY
National Provider Identifier
1083632111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R049116
- Practice address
- 496 Smithtown Byp Ste 304
Smithtown, NY 11787-5012 - Phone
- (631) 737-5559
- Fax
- (631) 737-0001
- NPI assigned
- Jul 17, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | |||
| Clinical Social Worker | 1041C0700X | R049116 | NY | Primary |
Addresses
Primary practice location
496 Smithtown Byp Ste 304
Smithtown, NY 11787-5012
Mailing address
3016 Hickory Valley Rd
Henderson, NV 89052-8507
Phone (631) 786-4202
Other names 1
- Diane E Freedman
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R049116 | NY | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Federation Employment and Guidance Service, Inc | Past | Accepting new patients | |
| Genoa Healthcare LLC | Past | Accepting new patients |
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.
-
- Clinical Social Worker
- Smithtown, NY
- NPI 1528223401
-
- Developmental Disabilities Clinic/Center
- New York, NY
- NPI 1942243084
-
- Long Term Care Pharmacy
- Brockton, MA
- NPI 1992521512
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718323200000",
"number": "1083632111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3016 HICKORY VALLEY RD",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890528507",
"telephone_number": "631-786-4202",
"fax_number": "631-737-0001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "496 SMITHTOWN BYP STE 304",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "117875012",
"telephone_number": "631-737-5559",
"fax_number": "631-737-0001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREEDMAN",
"first_name": "DIANE",
"middle_name": "E.",
"name_prefix": "Dr.",
"credential": "RLCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-17",
"last_updated": "2024-06-14",
"certification_date": "2024-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R049116",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DIANE",
"last_name": "FREEDMAN",
"middle_name": "E",
"credential": "PHD, LCSW-R",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Smithtown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; 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.