Lisette Diaz, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC06095800 Issued in NJ

Practice address

29 Morse Ave
Rutherford, NJ 07070-1250

Phone

(201) 450-7455

NPI assigned

Aug 11, 2014

Last updated

Oct 18, 2023By the provider in NPPES

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

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Synced LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rutherford, NJ
  • NPI 1295509362
  NPD Authorized official

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

{
    "created_epoch": "1407715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1689083099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 MORSE AVE",
            "city": "RUTHERFORD",
            "state": "NJ",
            "postal_code": "070701250",
            "telephone_number": "201-450-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 MORSE AVE",
            "city": "RUTHERFORD",
            "state": "NJ",
            "postal_code": "070701250",
            "telephone_number": "201-450-7455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "LISETTE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-11",
        "last_updated": "2023-10-18",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06095800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derrick Alloway Medical Arts, LLC
• Derrick Alloway Medical Arts, LLC
• Derrick Alloway Medical Arts, LLC
• Derrick Alloway Medical Arts, LLC
• Bhumika Desai, M.D.
• Maria E Diercks, PT
• Natasha Digenio
• Digestive Care of New Jersey, PA
• John J Digioia Jr., M.D.
• Erin Dannielle Dillon, RN, CLC

• Clinical Social Worker in Rutherford, NJ
• Providers in Rutherford, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.

Verify at the official NPI Registry.