Individual provider Active NPI

Diana Pacheco, LCSW

  • Clinical Social Worker
  • Louisville, KY
National Provider Identifier
1124435797
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
259268 Issued in KY
Practice address
4 Cardwell Way
Louisville, KY 40220-3584
Phone
(917) 750-5173
NPI assigned
Jul 16, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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 259268 KY Primary

Addresses

Primary practice location

4 Cardwell Way
Louisville, KY 40220-3584

Mailing address

4 Cardwell Way
Louisville, KY 40220-3584
Phone (917) 750-5173

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, NY, NJ3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20250822002652 KY Practitioner - Clinical Social Worker 5991205064 Reassigns benefits to 2 organizations
I20250904000975 NY Practitioner - Clinical Social Worker 5991205064 Reassigns benefits to 1 organization
I20250912003582 NJ Practitioner - Clinical Social Worker 5991205064 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4 Cardwell Way
Louisville, KY 40220-3584

500 Westover Dr
Sanford, NC 27330-8941

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
259268KYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group of New Jersey PC Clinical CurrentSince Aug 8, 2025 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Jul 29, 2025 Accepting new patients
Mental Health Specialty Group PA CurrentSince Aug 13, 2025 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

312 S 4th St
Louisville, KY 40202
Phone (502) 213-5590

312 S 4th St
Ste 700
Louisville, KY 40202
Phone (502) 628-5023

221 River St
Ste 9
Hoboken, NJ 07030
Phone (201) 439-8902

165 Broadway
Fl 23
New York, NY 10006
Phone (202) 972-4964

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": "1405468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1124435797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CARDWELL WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402203584",
            "telephone_number": "917-750-5173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 CARDWELL WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402203584",
            "telephone_number": "917-750-5173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHECO",
        "first_name": "DIANA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-16",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "259268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.