NPIMap

Individual provider Active NPI

Diana G Ruchelman, MSW, LCSW

  • Clinical Social Worker
  • Virginia Beach, VA
National Provider Identifier
1962437467
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904001533 Issued in VA
Practice address
260 Grayson Rd.
Jewish Family Service of Tidewater, Inc.
Virginia Beach, VA 23462-4345
Phone
(757) 459-4640
Fax
(757) 459-4643
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904001533 VA Primary

Addresses

Primary practice location

260 Grayson Rd.
Jewish Family Service of Tidewater, Inc.
Virginia Beach, VA 23462-4345

Mailing address

260 Grayson Rd.
Jewish Family Service of Tidewater, Inc.
Virginia Beach, VA 23462-4345
Phone (757) 459-4640

Other identifiers 2

IdentifierTypeStateIssuer
8907684MedicaidVA
063435OtherVABLUE CROSS

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0904001533VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Family Service of Tidewater, Incorporated Past Accepting new patients
Jewish Family Service of Tidewater, Incorporated Clinical PastSince May 1, 1993 Accepting new patients

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962437467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 GRAYSON RD.",
            "address_2": "JEWISH FAMILY SERVICE OF TIDEWATER, INC.",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234624345",
            "telephone_number": "757-459-4640",
            "fax_number": "757-459-4643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 GRAYSON RD.",
            "address_2": "JEWISH FAMILY SERVICE OF TIDEWATER, INC.",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234624345",
            "telephone_number": "757-459-4640",
            "fax_number": "757-459-4643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUCHELMAN",
        "first_name": "DIANA",
        "middle_name": "G",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904001533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8907684",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "063435",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.