Active NPI
Gladys Diaz, LCSW
- Clinical Social Worker
- New York, NY
National Provider Identifier
1417024506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R0278991
- Practice address
- 247 3Rd Ave
Suite 401
New York, NY 10010-7457 - Phone
- (212) 375-9070
- Fax
- (212) 979-3587
- NPI assigned
- Nov 30, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R0278991 | NY | Primary |
Addresses
Primary practice location
247 3Rd Ave
Suite 401
New York, NY 10010-7457
Mailing address
247 3Rd Ave
Suite 401
New York, NY 10010-7457
Phone (212) 375-9070
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4469017 | Other | NY | AETNA |
| N0I511 | Other | NY | BLUE CROSS & BLUE SHIELD |
| P3600713 | Other | NY | OXFORD |
| MIS# 721356000 | Other | NY | MAGELLAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R0278991 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214611200000",
"number": "1417024506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "247 3RD AVE",
"address_2": "SUITE 401",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100107457",
"telephone_number": "212-375-9070",
"fax_number": "212-979-3587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "247 3RD AVE",
"address_2": "SUITE 401",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100107457",
"telephone_number": "212-375-9070",
"fax_number": "212-979-3587"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "GLADYS",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-30",
"last_updated": "2008-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R0278991",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4469017",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS & BLUE SHIELD",
"identifier": "N0I511",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "P3600713",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN",
"identifier": "MIS# 721356000",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.