Individual provider Active NPI

Annette Deigh, MSW, LCSW

  • Clinical Social Worker
  • Philadelphia, PA
National Provider Identifier
1104110311
Registry record updated Jan 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW016868 Issued in PA
Practice address
6120B Woodland Avenue
Philadelphia, PA 19142
Phone
(267) 350-5940
Fax
(267) 597-3622
NPI assigned
Jun 6, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 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 CW016868 PA Primary

Addresses

Primary practice location

6120B Woodland Avenue
Philadelphia, PA 19142

Mailing address

4700 Wissahickon Avenue
BLDG D, Suite 118
Philadelphia, PA 19144-4248
Phone (610) 597-3600

Other names 1

  • Annette Owens-Johnson Former name

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
I20110805000064 PA Practitioner - Clinical Social Worker 6204005465 Reassigns benefits to 1 organization
Practice locations: Philadelphia, PA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW016868PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Resources for Human Development, Inc. CurrentSince Jan 1, 2015 Accepting new patients
Family Practice & Counseling Services Network, Inc. CurrentSince Jan 1, 2015 Accepting new patients
Resources for Human Development, Inc. Current Accepting new patients
Resources for Human Development, Inc. Past Accepting new patients
Family Practice & Counseling Services Network, Inc. Past Accepting new patients
Family Practice & Counseling Services Network, Inc. Past Accepting new patients

Locations

6120 Woodland Ave
Fl The
Philadelphia, PA 19142
Phone (215) 727-4721

4700 Wissahickon Ave
Ste 118
Philadelphia, PA 19144
Phone 26759736006771

2300 W Master St
Philadelphia, PA 19121
Phone (267) 687-1172

4700 Wissahickon Ave
Bldg D
Philadelphia, PA 19144
Phone (215) 843-9720

Organizations & group practices 6

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": "1307318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454025600000",
    "number": "1104110311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 WISSAHICKON AVENUE",
            "address_2": "BLDG D, SUITE 118",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191444248",
            "telephone_number": "610-597-3600",
            "fax_number": "267-597-3622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6120B WOODLAND AVENUE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19142",
            "telephone_number": "267-350-5940",
            "fax_number": "267-597-3622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEIGH",
        "first_name": "ANNETTE",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-06",
        "last_updated": "2016-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW016868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNETTE",
            "last_name": "OWENS-JOHNSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.