Individual provider Active NPI

Diane K Henry, LCSW-R

  • Clinical Social Worker
  • East Northport, NY
National Provider Identifier
1194899716
Registry record updated Mar 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
069843 Issued in NY
Practice address
554 Larkfield Rd
Ste 10C
East Northport, NY 11731-4205
Phone
(631) 923-8392
NPI assigned
Nov 17, 2006
Last updated
Mar 4, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2017

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 069843 NY Primary

Addresses

Primary practice location

554 Larkfield Rd
Ste 10C
East Northport, NY 11731-4205

Mailing address

554 Larkfield Rd
Ste 10C
East Northport, NY 11731-4205
Phone (631) 923-8392

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20170323001702 NY Practitioner - Clinical Social Worker 3971888439 Practice locations: East Northport, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

554 Larkfield Rd
Suite 10C
East Northport, NY 11731-4205
Phone (631) 923-8392

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Alan Weisman DPM PLLC PastSince Dec 14, 2009 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488585600000",
    "number": "1194899716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "554 LARKFIELD RD",
            "address_2": "STE 10C",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117314205",
            "telephone_number": "631-923-8392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "554 LARKFIELD RD",
            "address_2": "STE 10C",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117314205",
            "telephone_number": "631-923-8392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "DIANE",
        "middle_name": "K",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2017-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "069843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Northport, NY

Sources for this page

Verify at the official NPI Registry.