Individual provider Active NPI

Dianne Elizabeth Timmons, LCSW

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New York, NY
National Provider Identifier
1912419102
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Practice address
7 W 30TH St FL 9
New York, NY 10001-4406
Phone
(212) 725-7850
NPI assigned
Oct 29, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

7 W 30TH St FL 9
New York, NY 10001-4406

Mailing address

5831 Lawrence St
Flushing, NY 11355-5148
Phone (917) 963-9517

Other practice location 1

58-31 Lawrence Street
Flushing, NY 11355-4406
Phone (917) 963-9517

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20210510000613 NY Practitioner - Clinical Social Worker 8921417676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
JGB Mental Health and Mental Retardation Services IncGroup PAC ID 1850349838, 15 clinicians

Practice addresses (Care Compare)

250 W 64TH St
FL 4
New York, NY 10023-6402
Phone (212) 769-7800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
089078NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
JGB Mental Health & Mental Retardation Services Inc Mental Health (Including Community Mental Health Center) CurrentSince Apr 26, 2021 Accepting new patients
Blanton-Peale Institute Past Accepting new patients

Locations

250 W 64th St
Fl 4
New York, NY 10023

250 W 64th St
New York, NY 10023
Phone (212) 769-6247

Interoperability endpoints

  • Direct secure messaging: timmonsd@lighthouseguild.direct.welligent.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1509235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1912419102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5831 LAWRENCE ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555148",
            "telephone_number": "917-963-9517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 W 30TH ST FL 9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100014406",
            "telephone_number": "212-725-7850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "58-31 Lawrence Street",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113554406",
            "country_code": "US",
            "telephone_number": "917-963-9517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIMMONS",
        "first_name": "DIANNE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-29",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.