Individual provider Active NPI

Diane Elizabeth Smith, LCSW

  • School Social Worker
  • Tucson, AZ
National Provider Identifier
1831217660
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Social WorkerTaxonomy code 1041S0200X
License
LCSW-10554 Issued in AZ
Practice address
1010 E 10TH St
Tucson, AZ 85719-5813
Phone
(520) 225-6000
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X LCSW-10554 AZ Primary

Addresses

Primary practice location

1010 E 10TH St
Tucson, AZ 85719-5813

Mailing address

8638 S Desert Skyline PL
Tucson, AZ 85747-5146
Phone (520) 574-2586

Other identifiers 1

IdentifierTypeStateIssuer
777469MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250122000362 NM Practitioner - Clinical Social Worker 4587903596 Practice locations: Silver City, NM

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Silver City, NM 88061
Phone (520) 245-7096

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-10554AZMDSchool Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831217660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8638 S DESERT SKYLINE PL",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857475146",
            "telephone_number": "520-574-2586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 E 10TH ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857195813",
            "telephone_number": "520-225-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DIANE",
        "middle_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "AZ",
            "license": "LCSW-10554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "777469",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.