Maya Disko, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

117968 Issued in MA

Practice address

15 Story St
Cambridge, MA 02138

Phone

(617) 702-4811

NPI assigned

Nov 25, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Maya Reddy Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1385337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535932800000",
    "number": "1841620002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 MELROSE AVE",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024203034",
            "telephone_number": "617-702-4811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 STORY ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "02138",
            "telephone_number": "617-702-4811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISKO",
        "first_name": "MAYA",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-25",
        "last_updated": "2018-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "117968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAYA",
            "last_name": "REDDY",
            "credential": "LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessica Rose Dipietrantonio
• Maura Jean Dipietro, RN
• Kelly Dirstine, RN
• Benedict Joseph Dirusso Jr., R.PH., MBA
• Anthony Disciullo, MD
• Bruce R Ditzion, M.D.
• Joan Ditzion, LICSW
• Danny DO
• Yena H DO, DPM
• Son Thanh Doan

• Clinical Social Worker in Cambridge, MA
• Providers in Cambridge, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.