Individual provider Active NPI

Ryann Diaz, LCSW

  • Clinical Social Worker
  • St Petersburg, FL
National Provider Identifier
1689454563
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
22138 Issued in FL
Practice address
7901 4TH St N Ste 300
St Petersburg, FL 33702-4399
Phone
(910) 722-9590
NPI assigned
Sep 29, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X TLS.493.CP SC
Clinical Social Worker 1041C0700X 089.0135791 VT
Clinical Social Worker 1041C0700X 124393 IA
Clinical Social Worker 1041C0700X 0904016832 VA
Clinical Social Worker 1041C0700X LC23189 ME
Clinical Social Worker 1041C0700X C017495 NC
Clinical Social Worker 1041C0700X 22138 FL Primary

Addresses

Primary practice location

7901 4TH St N Ste 300
St Petersburg, FL 33702-4399

Mailing address

7901 4TH St N Ste 300
St Petersburg, FL 33702-4399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, DC, NC, IA, VT5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20231102004096 FL Practitioner - Clinical Social Worker 7113374711 Reassigns benefits to 1 organization
I20240802003574 DC Practitioner - Clinical Social Worker 7113374711 Reassigns benefits to 1 organization
I20241119003009 NC Practitioner - Clinical Social Worker 7113374711 Reassigns benefits to 1 organization
I20250131001740 IA Practitioner - Clinical Social Worker 7113374711 Reassigns benefits to 1 organization
I20260409002118 VT Practitioner - Clinical Social Worker 7113374711 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22138FLMDMental Health Counselor
124393IAMDClinical Social Worker
LC23189MEMDClinical Social Worker
TLS.493.CPSCMDClinical Social Worker
0904016832VAMDClinical Social Worker
089.0135791VTMDClinical Social Worker

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1695945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1689454563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 4TH ST N STE 300",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337024399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 4TH ST N STE 300",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337024399",
            "telephone_number": "910-722-9590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "RYANN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-29",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "TLS.493.CP",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089.0135791",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "124393",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904016832",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC23189",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C017495",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "22138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.