Individual provider Active NPI

Diane Lynn, L.C.S.W

  • Clinical Social Worker
  • Staten Island, NY
National Provider Identifier
1386705358
Registry record updated Jan 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R061055 Issued in NY
Practice address
8 Temple CT
Staten Island, NY 10314-4784
Phone
(718) 983-5893
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2017

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 R061055 NY Primary

Addresses

Primary practice location

8 Temple CT
Staten Island, NY 10314-4784

Mailing address

8 Temple CT
Staten Island, NY 10314-4784
Phone (718) 494-2089

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120313000016 NY Practitioner - Clinical Social Worker 3476712332 Practice locations: Staten Island, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8 Temple Court
Staten Island, NY 10314-4784
Phone (917) 576-1885

8 Temple CT
Staten Island, NY 10314-4784

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R061055NYMDClinical Social Worker
061055NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483488000000",
    "number": "1386705358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 TEMPLE CT",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103144784",
            "telephone_number": "718-494-2089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 TEMPLE CT",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103144784",
            "telephone_number": "718-983-5893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNN",
        "first_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2017-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R061055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.