Individual provider Active NPI

Diane Rullo, PHD, LCSW, LMFT,

  • Clinical Social Worker
  • Orlando, FL
National Provider Identifier
1467519959
Registry record updated Jun 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW7993 Issued in FL
Practice address
7800 W Sand Lake Rd
Suite 207
Orlando, FL 32819-5416
Phone
(407) 455-1347
NPI assigned
Jan 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 37LC00106400 NJ
Clinical Social Worker 1041C0700X SW7993 FL Primary
Clinical Social Worker 1041C0700X 44SC00022300 NJ

Addresses

Primary practice location

7800 W Sand Lake Rd
Suite 207
Orlando, FL 32819-5416

Mailing address

7800 W Sand Lake Rd
Suite 207
Orlando, FL 32819-5416
Phone (407) 455-1347

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
37LC00106400NJMDAddiction (Substance Use Disorder) Counselor
SW7993FLMDClinical Social Worker
44SC00022300NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402963200000",
    "number": "1467519959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 W SAND LAKE RD",
            "address_2": "SUITE 207",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328195416",
            "telephone_number": "407-455-1347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 W SAND LAKE RD",
            "address_2": "SUITE 207",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328195416",
            "telephone_number": "407-455-1347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RULLO",
        "first_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "PHD, LCSW, LMFT,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2014-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00106400",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW7993",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC00022300",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2014; 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.