Active NPI
Jillian Diaz, LMSW
- Social Worker
- Bronx, NY
National Provider Identifier
1790499028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 115355
- Practice address
- 1015 Fox St
Bronx, NY 10459-3258 - Phone
- (718) 328-3585
- NPI assigned
- Jan 11, 2023
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 115355 | NY | Primary |
Addresses
Primary practice location
1015 Fox St
Bronx, NY 10459-3258
Mailing address
68 Blackman PL
Bridgeport, CT 06604-2424
Phone (718) 709-1642
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 115355 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673395200000",
"number": "1790499028",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "68 BLACKMAN PL",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066042424",
"telephone_number": "718-709-1642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1015 FOX ST",
"city": "BRONX",
"state": "NY",
"postal_code": "104593258",
"telephone_number": "718-328-3585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "JILLIAN",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-01-11",
"last_updated": "2023-01-11",
"certification_date": "2023-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "115355",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.