Individual provider Active NPI

Diane M Disalvo, LCSWR

  • Clinical Social Worker
  • Staten Island, NY
National Provider Identifier
1245534643
Registry record updated Dec 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R031597-1 Issued in NY
Practice address
777 Seaview Ave
SBPC Adolescent Unit, Building 7
Staten Island, NY 10305-3409
Phone
(718) 667-2763
Fax
(718) 667-2586
NPI assigned
Dec 29, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2010

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 R031597-1 NY Primary

Addresses

Primary practice location

777 Seaview Ave
SBPC Adolescent Unit, Building 7
Staten Island, NY 10305-3409

Mailing address

337 Bement Ave
Staten Island, NY 10310-2138
Phone (718) 815-4231

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

LicenseStateTypeSpecialty
R031597-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1293580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293580800000",
    "number": "1245534643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "337 BEMENT AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103102138",
            "telephone_number": "718-815-4231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 SEAVIEW AVE",
            "address_2": "SBPC ADOLESCENT UNIT, BUILDING 7",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053409",
            "telephone_number": "718-667-2763",
            "fax_number": "718-667-2586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISALVO",
        "first_name": "DIANE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LCSWR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-29",
        "last_updated": "2010-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R031597-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2010; 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.