Organization Active NPI

Diverleaf LLC

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1295695567
Registry record updated Apr 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
DIVERLEAF LLC
Practice address
606 Baltimore Ave Ste 207
Baltimore, MD 21204-4097
Phone
(202) 813-9773
NPI assigned
Nov 17, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2026

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

Authorized official

Name
Megan P Miller, LCSW-CNPI 1801167606
Title
Owner
Phone
(202) 813-9773

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

606 Baltimore Ave Ste 207
Baltimore, MD 21204-4097

Mailing address

606 Baltimore Ave Ste 207
Baltimore, MD 21204-4097
Phone (202) 813-9773

Other identifiers 1

IdentifierTypeStateIssuer
17348OtherMDLCSW-C

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260302003730 MD Part B Supplier - Clinic/Group Practice 0648752485 Receives reassigned benefits from 1 practitioner
Practice locations: Baltimore, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1763337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775001600000",
    "number": "1295695567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 BALTIMORE AVE STE 207",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212044097",
            "telephone_number": "202-813-9773",
            "fax_number": "202-747-5539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 BALTIMORE AVE STE 207",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212044097",
            "telephone_number": "202-813-9773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERLEAF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-17",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "202-813-9773",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW-C",
            "identifier": "17348",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.