Individual provider Active NPI

Diari Marcus Banigo

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1801192083
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
100778 Issued in CA
Practice address
113 E 25TH St
First Floor
Baltimore, MD 21218-5248
Phone
(410) 900-3144
NPI assigned
Feb 4, 2011
Last updated
Jun 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Clinical Social Worker 1041C0700X 100778 CA Primary

Addresses

Primary practice location

113 E 25TH St
First Floor
Baltimore, MD 21218-5248

Mailing address

P. O. Box 805
Bel Air, MD 21014
Phone (410) 900-3147

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, DC2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20210728003824 CA Practitioner - Clinical Social Worker 1254635576 Reassigns benefits to 1 organization
Practice locations: Fresno, CA
I20230911002801 DC Practitioner - Clinical Social Worker 1254635576 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
100778CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Clinical CurrentSince Jan 25, 2023 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Aug 9, 2023 Accepting new patients
Banigo Behavioral Health Group PHD Licensed Clinical Social Worker Clinical Current Accepting new patients
Aspire Counseling Services Past Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1296777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1801192083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P. O. BOX 805",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "21014",
            "telephone_number": "410-900-3147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 E 25TH ST",
            "address_2": "FIRST FLOOR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185248",
            "telephone_number": "410-900-3144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANIGO",
        "first_name": "DIARI",
        "middle_name": "MARCUS",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-04",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "100778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.