Diana Klebanoff, LCSWR

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

026511 Issued in NY

Practice address

1 Commons Dr
Lake Katrine, NY 12449-5149

Phone

(845) 336-6666

NPI assigned

Dec 23, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mental Health Specialty Group PAGroup PAC ID 8921466228, 726 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  NY

  Medicare reassignment Care Compare group NPD
• Che Senior Psychological Services, PC

  • Clinical Psychologist
  • Brooklyn, NY
  • NPI 1023078219
  Medicare reassignment NPD
• Knapp Street Psychiatry, PC

  • Clinical Psychologist
  • Brooklyn, NY
  • NPI 1043248776
  Medicare reassignment NPD

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

{
    "created_epoch": "1577059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577059200000",
    "number": "1639718620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 NORTH LOOP",
            "city": "RHINEBECK",
            "state": "NY",
            "postal_code": "125721921",
            "telephone_number": "845-876-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COMMONS DR",
            "city": "LAKE KATRINE",
            "state": "NY",
            "postal_code": "124495149",
            "telephone_number": "845-336-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEBANOFF",
        "first_name": "DIANA",
        "credential": "LCSWR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-23",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "026511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karin Connelly PHD Psychology Coaching PLLC
• Taeyoung Kim, DDS
• Kingston NH Operation LLC
• Kenneth T Kircher, DO
• Jean M Kirtio, PHYSICAL THER. ASST
• Roy A Kline, O.D.
• Joon-Yong Koh
• Diane J. Kraus, MD
• KRNH Inc
• KRNH, Inc

• Clinical Social Worker in Lake Katrine, NY
• Providers in Lake Katrine, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.