Individual provider Active NPI

Diana Goodenough, LCSW

  • Social Worker
  • Roslyn, NY
National Provider Identifier
1588776868
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
073439-1 Issued in NY
Practice address
1025 Northern Blvd Ste 201
Roslyn, NY 11576-1506
Phone
(516) 282-6327
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 073439-1 NY Primary

Addresses

Primary practice location

1025 Northern Blvd Ste 201
Roslyn, NY 11576-1506

Mailing address

1025 Northern Blvd Ste 201
Roslyn, NY 11576-1506
Phone (516) 282-6327

Other practice location 1

60 Walnut Ave
East Norwich, NY 11732-1416
Phone (516) 922-6688

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
073439-1NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1588776868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 NORTHERN BLVD STE 201",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761506",
            "telephone_number": "516-282-6327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 NORTHERN BLVD STE 201",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761506",
            "telephone_number": "516-282-6327"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60 Walnut Ave",
            "address_purpose": "LOCATION",
            "city": "East Norwich",
            "state": "NY",
            "postal_code": "117321416",
            "country_code": "US",
            "telephone_number": "516-922-6688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODENOUGH",
        "first_name": "DIANA",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "073439-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn, NY

Sources for this page

  • 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.