Individual provider Active NPI

Candida Deluise, MSW

  • Clinical Social Worker
  • Washington, DC
National Provider Identifier
1407077175
Registry record updated Jan 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
05565 Issued in MD
Practice address
3000 Connecticut Ave NW
Suite 306
Washington, DC 20008-2509
Phone
(202) 387-7931
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 05565 MD Primary
Clinical Social Worker 1041C0700X LC301937 DC

Addresses

Primary practice location

3000 Connecticut Ave NW
Suite 306
Washington, DC 20008-2509

Mailing address

7715 Takoma Ave
Takoma Park, MD 20912-4118
Phone (202) 387-7931

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20120314000334 DC Practitioner - Clinical Social Worker 4880853647 Practice locations: Washington DC, DC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3000 Connecticut Ave NW
Suite 435
Washington DC, DC 20008-2556
Phone (202) 387-7931

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC301937DCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325808000000",
    "number": "1407077175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7715 TAKOMA AVE",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "209124118",
            "telephone_number": "202-387-7931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 CONNECTICUT AVE NW",
            "address_2": "SUITE 306",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200082509",
            "telephone_number": "202-387-7931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELUISE",
        "first_name": "CANDIDA",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2012-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "05565",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC301937",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.