Individual provider Active NPI

Diane R Bossung, LCSW-R

  • Clinical Social Worker
  • Schenectady, NY
National Provider Identifier
1639568439
Registry record updated Jan 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R-041086-1 Issued in NY
Practice address
530 Franklin St
Schenectady, NY 12305-2011
Phone
(518) 381-8911
NPI assigned
Jan 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R-041086-1 NY Primary

Addresses

Primary practice location

530 Franklin St
Schenectady, NY 12305-2011

Mailing address

530 Franklin St
Schenectady, NY 12305-2011
Phone (518) 381-8911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 1, 2023 through Apr 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R-041086-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1421366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421366400000",
    "number": "1639568439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 FRANKLIN ST",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123052011",
            "telephone_number": "518-381-8911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 FRANKLIN ST",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123052011",
            "telephone_number": "518-381-8911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSSUNG",
        "first_name": "DIANE",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-16",
        "last_updated": "2015-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R-041086-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schenectady, NY

Sources for this page

Verify at the official NPI Registry.