Debra Diane, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW10293 Issued in FL

Practice address

2900 W Prospect Rd
Fort Lauderdale, FL 33309-2519

Phone

(954) 731-5100

Fax

(954) 497-3857

NPI assigned

Jul 11, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Clinical Social Worker

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Blue Moon Senior CounselingGroup PAC ID 6103099759, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Blue Moon Senior Counseling

  • Clinical Social Worker
  • Plainfield, IL
  • NPI 1205129186

  FL

  Medicare reassignment Care Compare group NPD
• Henderson Behavioral Health, Inc.

  • Family Medicine Physician
  • Ft Lauderdale, FL
  • NPI 1053262709
  NPD (past)
• Henderson Behavioral Health, Inc.

  • Community/Behavioral Health Agency
  • Lauderdale Lakes, FL
  • NPI 1972533271
  NPD (past)

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1861757239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4740 N STATE ROAD 7 STE 201",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333195839",
            "telephone_number": "954-777-1617",
            "fax_number": "954-497-3857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 W PROSPECT RD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333092519",
            "telephone_number": "954-731-5100",
            "fax_number": "954-497-3857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIANE",
        "first_name": "DEBRA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-11",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW10293",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW10293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diagnostic MD, LLC
• Diamond Health Services,Inc.
• Peter E Diamond, DC
• Diana Nomikos Katz PA
• Diana P. Camargo O.D., P.a.
• Erudice Pascale Diaquoi-Reeves
• Keyla Diaz - Medina, M.D.
• Yenisleidy Diaz Collado
• Aimed Diaz Reynaldo
• Claudio Diaz-Socarras, MD

• Clinical Social Worker in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.