Amy Diaz, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

124219 Issued in MA

Practice address

628 Center St
Chicopee, MA 01013-1589

Phone

(413) 746-0051

NPI assigned

Jan 8, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Community Health Care, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Westfield, MA
  • NPI 1912980251

  Addiction (Substance Use Disorder)

  NPD (past)
• Community Physicians PC

  • Methadone Clinic
  • Portland, ME
  • NPI 1316242209
  NPD (past)

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

{
    "created_epoch": "1389139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1356763544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 PARK ST",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "010893314",
            "telephone_number": "413-737-4718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 CENTER ST",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010131589",
            "telephone_number": "413-746-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "AMY",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-08",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "124219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Eric Despard
• Jacqueline A Desrosiers, R.PH.
• Dialysis Center of Western Massachusetts LLC
• Jazzmary Diana
• Allyn Diaz
• Darius Diaz
• Jefferson Haley Dickey, MD
• Sergey Dikan
• Dmaktin
• Diego Leonardo Dominguez

• Clinical Social Worker in Chicopee, MA
• Providers in Chicopee, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; 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.