Individual provider Active NPI

Laurel Dietterle, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1932090602
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
482 Willoughby Ave Apt 1
Brooklyn, NY 11206-6482
Phone
(815) 351-1673
NPI assigned
Jul 11, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NY Primary
Social Worker 104100000X 112666 NY

Addresses

Primary practice location

482 Willoughby Ave Apt 1
Brooklyn, NY 11206-6482

Mailing address

482 Willoughby Ave Apt 1
Brooklyn, NY 11206-6482
Phone (815) 351-1673

Other practice location 1

3635 Bell Blvd Ste 203
Bayside, NY 11361-2097
Phone (718) 504-9256

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
I20251003003321 NY Practitioner - Clinical Social Worker 6709382013 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Counseling LCSW PLLCGroup PAC ID 3870754427, 46 clinicians

Practice addresses (Care Compare)

3635 Bell Blvd
Suite 203
Bayside, NY 11361-2097
Phone (718) 830-0246

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
112666NYMDSocial Worker
100922NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Counseling LCSW, PLLC Clinical CurrentSince Sep 29, 2025 Accepting new patients

Locations

2 Main St
Ste 2A
Plymouth, MA 02360

3635 Bell Blvd
Ste 203
Bayside, NY 11361
Phone (718) 504-9256

Organizations & group practices 1

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": "1752192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1932090602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "482 WILLOUGHBY AVE APT 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112066482",
            "telephone_number": "815-351-1673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "482 WILLOUGHBY AVE APT 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112066482",
            "telephone_number": "815-351-1673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3635 Bell Blvd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Bayside",
            "state": "NY",
            "postal_code": "113612097",
            "country_code": "US",
            "telephone_number": "718-504-9256",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIETTERLE",
        "first_name": "LAUREL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-11",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "112666",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.