Active NPI
Carolyn Perry Diaz, LCSW
- Clinical Social Worker
- Sheridan, WY
National Provider Identifier
1205976263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C000312
- Practice address
- 1898 Fort Rd
Building 64
Sheridan, WY 82801-8320 - Phone
- (307) 672-3473
- NPI assigned
- Feb 7, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C000312 | NC | Primary |
Addresses
Primary practice location
1898 Fort Rd
Building 64
Sheridan, WY 82801-8320
Mailing address
1898 Fort Rd
House 14a
Sheridan, WY 82801-8320
Phone (307) 674-6755
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C000312 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205976263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1898 FORT RD",
"address_2": "HOUSE 14A",
"city": "SHERIDAN",
"state": "WY",
"postal_code": "828018320",
"telephone_number": "307-674-6755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1898 FORT RD",
"address_2": "BUILDING 64",
"city": "SHERIDAN",
"state": "WY",
"postal_code": "828018320",
"telephone_number": "307-672-3473"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "CAROLYN",
"middle_name": "PERRY",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C000312",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sheridan, WY
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.