Diane Jordan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

076967-1 Issued in NY

Practice address

57 E Fulton St
Gloversville, NY 12078-3212

Phone

(518) 773-3531

NPI assigned

Oct 15, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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.

• Rehabilitation Support Services, Inc

  • Mental Illness Community Based Residential Treatment Facility
  • Altamont, NY
  • NPI 1922293745
  NPD (past)

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

{
    "created_epoch": "1255564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1487989018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 E FULTON ST",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "120783212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 E FULTON ST",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "120783212",
            "telephone_number": "518-773-3531"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "314 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122062522",
            "country_code": "US",
            "telephone_number": "518-462-1094 x239",
            "fax_number": "518-462-1097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "DIANE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-15",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "076967-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Joseph Jankunas Jr., DC
• John L Glenn MD
• John M. Fox D.D.S.
• Barbara Jean Johnson, LPN
• Carrin Johnston
• Joseph M Lander Realty, Inc
• Aaron Julca
• Kamini S. Ramani M.D., P.C
• Kathleen Marie Kane, RN
• Kate E. Perham DMD PC

• Clinical Social Worker in Gloversville, NY
• Providers in Gloversville, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.