Individual provider Active NPI

Diane E. Freedman, RLCSW

  • Clinical Social Worker
  • Smithtown, NY
National Provider Identifier
1083632111
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R049116 Issued in NY
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

Updated by the provider on Jun 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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 Other name

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
I20040715000893 NY Practitioner - Clinical Social Worker 4587643390 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R049116NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.