Active NPI
Diana Lynn King, LCSW
- Clinical Social Worker
- Fredericksburg, VA
National Provider Identifier
1609962125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904005637
- Practice address
- 10700 Ballantraye Dr
Ste 104
Fredericksburg, VA 22407-4700 - Phone
- (540) 479-2211
- Fax
- (540) 301-0500
- NPI assigned
- Oct 4, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | 0904005637 | VA | Primary |
Addresses
Primary practice location
10700 Ballantraye Dr
Ste 104
Fredericksburg, VA 22407-4700
Mailing address
10700 Ballantraye Dr
Ste 104
Fredericksburg, VA 22407-4700
Phone (540) 479-2211
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 144491 | Other | VA | KEY CARE, FEDERAL BC/BS |
| 73437800 | Other | VA | MAGELLAN, VALUE OPTIONS |
| M546 | Other | VA | CAREFIRST |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339372800000",
"number": "1609962125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10700 BALLANTRAYE DR",
"address_2": "STE 104",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224074700",
"telephone_number": "540-479-2211",
"fax_number": "540-301-0500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10700 BALLANTRAYE DR",
"address_2": "STE 104",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224074700",
"telephone_number": "540-479-2211",
"fax_number": "540-301-0500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "DIANA",
"middle_name": "LYNN",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-04",
"last_updated": "2012-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904005637",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEY CARE, FEDERAL BC/BS",
"identifier": "144491",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN, VALUE OPTIONS",
"identifier": "73437800",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST",
"identifier": "M546",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fredericksburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.