Active NPI
Dayle Wild, LCSW-R
- Clinical Social Worker
- New York, NY
National Provider Identifier
1669656757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 73 069317
- Practice address
- 900 W End Ave
New York, NY 10025-3547 - Phone
- (516) 662-2612
- NPI assigned
- Dec 25, 2007
- 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 | 73 069317 | NY | Primary |
Addresses
Primary practice location
900 W End Ave
New York, NY 10025-3547
Mailing address
PO Box 917
New York, NY 10025-0917
Phone (516) 662-2612
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 8, 2024 through Jul 8, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 73 069317 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198540800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724112000000",
"number": "1669656757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 917",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100250917",
"telephone_number": "516-662-2612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 W END AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100253547",
"telephone_number": "516-662-2612"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILD",
"first_name": "DAYLE",
"name_prefix": "Ms.",
"credential": "LCSW-R",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-25",
"last_updated": "2024-08-20",
"certification_date": "2024-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "73 069317",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.