Individual provider Active NPI

Diana Kwiecinski, MSW, LCSW

  • Clinical Social Worker
  • Cherry Hill, NJ
National Provider Identifier
1194939090
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC01304000 Issued in NJ
Practice address
1040 Kings Hwy N
Suite 100
Cherry Hill, NJ 08034-1908
Phone
(856) 414-1155
NPI assigned
May 9, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 44SC01304000 NJ Primary

Addresses

Primary practice location

1040 Kings Hwy N
Suite 100
Cherry Hill, NJ 08034-1908

Mailing address

PO Box 1074
Medford, NJ 08055-6074
Phone (908) 881-4368

Other identifiers 1

IdentifierTypeStateIssuer
44SC01304000OtherNJLIC CLINICAL SOCIAL WORKE

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

LicenseStateTypeSpecialty
44SC01304000NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Anil K Gupta MD PA Past Accepting new patients
Adaptive Home Therapy, Inc. PastSince Feb 27, 1996 Accepting new patients
Lighthouse Hospice Inc. Past Accepting new patients

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, 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": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194939090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1074",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080556074",
            "telephone_number": "908-881-4368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 KINGS HWY N",
            "address_2": "SUITE 100",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080341908",
            "telephone_number": "856-414-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWIECINSKI",
        "first_name": "DIANA",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC01304000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC CLINICAL SOCIAL WORKE",
            "identifier": "44SC01304000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.