Active NPI
Alfonso Diaz, LCSW, LCDC
- Clinical Social Worker
- El Paso, TX
National Provider Identifier
1306175377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 52967
- Practice address
- 3860 Tierra Campa Dr
El Paso, TX 79938-4372 - Phone
- (915) 549-5197
- NPI assigned
- Dec 21, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 10381 | TX | |
| Clinical Social Worker | 1041C0700X | 52967 | TX | Primary |
Addresses
Primary practice location
3860 Tierra Campa Dr
El Paso, TX 79938-4372
Mailing address
3860 Tierra Campa Dr
El Paso, TX 79938-4372
Phone (915) 549-5197
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Apr 20, 2017 through Apr 20, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 52967 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1261353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395273600000",
"number": "1306175377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3860 TIERRA CAMPA DR",
"city": "EL PASO",
"state": "TX",
"postal_code": "799384372",
"telephone_number": "915-549-5197"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3860 TIERRA CAMPA DR",
"city": "EL PASO",
"state": "TX",
"postal_code": "799384372",
"telephone_number": "915-549-5197"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "ALFONSO",
"credential": "LCSW, LCDC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-12-21",
"last_updated": "2014-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TX",
"license": "10381",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "52967",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Paso, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.