Active NPI
Lucia Leo- Diaz, LCSW
- Clinical Social Worker
- Mission, TX
National Provider Identifier
1104135094
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 17284
- Practice address
- 1200 N Dunlap Ave
Suite a
Mission, TX 78572-3933 - Phone
- (956) 222-3552
- Fax
- (956) 585-8984
- NPI assigned
- Sep 27, 2010
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 17284 | TX | Primary |
Addresses
Primary practice location
1200 N Dunlap Ave
Suite a
Mission, TX 78572-3933
Mailing address
1200 N Dunlap Ave
Suite a
Mission, TX 78572-3933
Phone (956) 222-3552
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17284 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285545600000",
"number": "1104135094",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 N DUNLAP AVE",
"address_2": "SUITE A",
"city": "MISSION",
"state": "TX",
"postal_code": "785723933",
"telephone_number": "956-222-3552",
"fax_number": "956-585-8984"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 N DUNLAP AVE",
"address_2": "SUITE A",
"city": "MISSION",
"state": "TX",
"postal_code": "785723933",
"telephone_number": "956-222-3552",
"fax_number": "956-585-8984"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "LUCIA",
"middle_name": "LEO-",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-09-27",
"last_updated": "2010-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "17284",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mission, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.