Active NPI
Diane Wacks, LCSW
- Clinical Social Worker
- Plantation, FL
National Provider Identifier
1609890920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW6975
- Practice address
- 100 S Pine Island Rd
Ste 230
Plantation, FL 33324-2613 - Phone
- (954) 370-2140
- Fax
- (954) 916-1252
- NPI assigned
- Jul 27, 2006
- Sex
- Female
- Sole proprietor
- No
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 | SW6975 | FL | Primary |
Addresses
Primary practice location
100 S Pine Island Rd
Ste 230
Plantation, FL 33324-2613
Mailing address
8710 Lake Dasha Ter
Plantation, FL 33324-3121
Phone (954) 562-0451
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 |
|---|---|---|---|
| SW6975 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1609890920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8710 LAKE DASHA TER",
"city": "PLANTATION",
"state": "FL",
"postal_code": "333243121",
"telephone_number": "954-562-0451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 S PINE ISLAND RD",
"address_2": "STE 230",
"city": "PLANTATION",
"state": "FL",
"postal_code": "333242613",
"telephone_number": "954-370-2140",
"fax_number": "954-916-1252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WACKS",
"first_name": "DIANE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-27",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW6975",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plantation, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.