Bradley Diskin

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

15692 Issued in FL

Practice address

5410 East Ave
West Palm Beach, FL 33407-2344

Phone

(954) 551-4814

NPI assigned

Oct 9, 2020

Last updated

Oct 9, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1602201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1972101244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5410 EAST AVE",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5410 EAST AVE",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072344",
            "telephone_number": "954-551-4814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISKIN",
        "first_name": "BRADLEY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-09",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "15692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1881792745",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "alternativesintreatment.kipuworks.com",
            "affiliation": "N",
            "endpointDescription": "KIPU EMR",
            "address_1": "5410 East Ave",
            "city": "West Palm Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334072344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinical Social Worker in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; 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.