Diane Brieloff Kelly, RCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R043361-1 Issued in NY

Practice address

27 Adam Rd W
Massapequa, NY 11758-8003

Phone

(516) 972-0031

NPI assigned

Feb 23, 2021

Last updated

Feb 23, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1614038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1174117923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 ADAM RD W",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117588003",
            "telephone_number": "516-972-0031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 ADAM RD W",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117588003",
            "telephone_number": "516-972-0031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIELOFF KELLY",
        "first_name": "DIANE",
        "credential": "RCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-23",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R043361-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "laptop",
            "affiliation": "N",
            "address_1": "27 Adam Rd W",
            "city": "Massapequa",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117588003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinical Social Worker in Massapequa, NY
• Providers in Massapequa, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.