Jessalyn Marie Difazio, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

121061 Issued in NY

Practice address

391 Western Ave
Albany, NY 12203-1491

Phone

(518) 242-4731

NPI assigned

Dec 20, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1703030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1235907148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4984 ROUTE 209",
            "city": "ACCORD",
            "state": "NY",
            "postal_code": "124045718",
            "telephone_number": "845-399-4194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 WESTERN AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122031491",
            "telephone_number": "518-242-4731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIFAZIO",
        "first_name": "JESSALYN",
        "middle_name": "MARIE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-20",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "121061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Joseph Dickson III
• Theresa Viola Dicroce, P.T.A.
• Charlotte Diefenbach
• Amber Marie Dier, PA
• Krista Dietershagen, FNP-BC
• Daniel P. Digiacomo, DDS
• Christa Dijstelbergen, PT
• Alexa Dillenbeck
• Ann M Dillon, LCSW
• Jennifer Kathleen Dillon, LMSW

• Social Worker in Albany, NY
• Providers in Albany, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; 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.