Individual provider Active NPI

Diane L Davis, MSW, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1578745675
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
077623 Issued in NY
Practice address
244 5TH Ave Ste 9G
New York, NY 10001-7604
Phone
(917) 885-9139
NPI assigned
Nov 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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 SC053436000 NJ
Clinical Social Worker 1041C0700X 077623 NY Primary

Addresses

Primary practice location

244 5TH Ave Ste 9G
New York, NY 10001-7604

Mailing address

10 Crestmont Rd Apt 1D
Montclair, NJ 07042-1900
Phone (917) 885-9139

Other practice location 1

94 Valley Rd
Montclair, NJ 07042-2211
Phone (917) 885-9139

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
I20131119000819 NY Practitioner - Clinical Social Worker 4486880531 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

49 W 24TH St
Suite 910
New York, NY 10010-3504
Phone (917) 885-9139

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC053436000NJMDClinical Social Worker
077623NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1578745675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CRESTMONT RD APT 1D",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070421900",
            "telephone_number": "917-885-9139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 5TH AVE STE 9G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100017604",
            "telephone_number": "917-885-9139"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "94 Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Montclair",
            "state": "NJ",
            "postal_code": "070422211",
            "country_code": "US",
            "telephone_number": "917-885-9139",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DIANE",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-29",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "SC053436000",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "077623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.