Active NPI
Dianne Mack
- Clinical Social Worker
- New York, NY
National Provider Identifier
1912354788
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 076408-1
- Practice address
- 1727 Amsterdam Ave
New York, NY 10031-4611 - Phone
- (212) 694-9200
- Fax
- (212) 368-5608
- NPI assigned
- May 20, 2016
- Last updated
- May 20, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 076408-1 | NY | Primary |
Addresses
Primary practice location
1727 Amsterdam Ave
New York, NY 10031-4611
Mailing address
1727 Amsterdam Ave
New York, NY 10031-4611
Phone (212) 694-9200
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 |
|---|---|---|---|
| 076408-1 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463702400000",
"number": "1912354788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1727 AMSTERDAM AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100314611",
"telephone_number": "212-694-9200",
"fax_number": "212-368-5608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1727 AMSTERDAM AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100314611",
"telephone_number": "212-694-9200",
"fax_number": "212-368-5608"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACK",
"first_name": "DIANNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-20",
"last_updated": "2016-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "076408-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.