Lisette Diaz, LCSW
Individual provider Active NPI Clinical Social Worker · Rutherford, NJ
NPI 1689083099 · NPPES record last updated Oct 18, 2023
Key facts
- NPI
- 1689083099
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 44SC06095800 (NJ)
- Practice address
- 29 Morse Ave
Rutherford, NJ 07070-1250 - Phone
- (201) 450-7455
- NPI assigned
- Aug 11, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44SC06095800 | NJ | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Synced LLC | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 44SC06095800 | NJ | Yes |
Addresses
Primary practice location
29 Morse Ave
Rutherford, NJ 07070-1250
Mailing address
29 Morse Ave
Rutherford, NJ 07070-1250
Phone (201) 450-7455
Other providers in Rutherford, NJ
- Derrick Alloway Medical Arts, LLC
- Derrick Alloway Medical Arts, LLC
- Derrick Alloway Medical Arts, LLC
- Derrick Alloway Medical Arts, LLC
- Bhumika Desai
- Maria E Diercks
- Natasha Digenio
- Digestive Care of New Jersey, PA
- John J Digioia Jr.
- Erin Dannielle Dillon
All providers in Rutherford, NJ · Clinical Social Worker in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.