Active NPI
Diane Saccoccio, LCSW-C
- Social Worker
- Prince Frederick, MD
National Provider Identifier
1881988400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 16961
- Practice address
- 305 Prince Frederick Blvd
Prince Frederick, MD 20678-3139 - Phone
- (410) 535-4787
- Fax
- (410) 535-4965
- NPI assigned
- May 31, 2011
- 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 | 16961 | MD | Primary |
Addresses
Primary practice location
305 Prince Frederick Blvd
Prince Frederick, MD 20678-3139
Mailing address
2516 Coxshire LN
Davidsonville, MD 21035-1153
Phone (301) 535-2837
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16961 | MD | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422403200000",
"number": "1881988400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2516 COXSHIRE LN",
"city": "DAVIDSONVILLE",
"state": "MD",
"postal_code": "210351153",
"telephone_number": "301-535-2837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 PRINCE FREDERICK BLVD",
"city": "PRINCE FREDERICK",
"state": "MD",
"postal_code": "206783139",
"telephone_number": "410-535-4787",
"fax_number": "410-535-4965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SACCOCCIO",
"first_name": "DIANE",
"credential": "LCSW-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-31",
"last_updated": "2015-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MD",
"license": "16961",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prince Frederick, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.