Individual provider Active NPI

Diane Rita Hull, LCSW-C

  • Clinical Social Worker
  • Gaithersburg, MD
National Provider Identifier
1164616256
Registry record updated Aug 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
04600 Issued in MD
Practice address
9077 Shady Grove CT
Gaithersburg, MD 20877-1301
Phone
(301) 891-5586
Fax
(301) 891-5596
NPI assigned
Aug 31, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2007

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 04600 MD Primary

Addresses

Primary practice location

9077 Shady Grove CT
Gaithersburg, MD 20877-1301

Mailing address

9077 Shady Grove CT
Gaithersburg, MD 20877-1301
Phone (301) 891-5586

Other identifiers 2

IdentifierTypeStateIssuer
6802419 00MedicaidMD
6802419 01MedicaidMD

Other names 1

  • Miss Diane Rita Roberts Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20160328001121 DC Practitioner - Clinical Social Worker 9830496470 Practice locations: Silver Spring, MD; Gaithersburg, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

8605 Cameron St
Suite 218
Silver Spring, MD 20910-3728
Phone (301) 520-2889

9077 Shady Grove CT
Gaithersburg, MD 20877-1301
Phone (301) 520-2889

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
04600MDMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188518400000",
    "number": "1164616256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9077 SHADY GROVE CT",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208771301",
            "telephone_number": "301-891-5586",
            "fax_number": "301-891-5596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9077 SHADY GROVE CT",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208771301",
            "telephone_number": "301-891-5586",
            "fax_number": "301-891-5596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HULL",
        "first_name": "DIANE",
        "middle_name": "RITA",
        "name_prefix": "Mrs.",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-31",
        "last_updated": "2007-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "04600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6802419 00",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6802419 01",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "ROBERTS",
            "middle_name": "RITA",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gaithersburg, MD

Sources for this page

Verify at the official NPI Registry.