Healthcare Provider Details

I. General information

NPI: 1982940490
Provider Name (Legal Business Name): DICODA DIANDRA WESTBROOK LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2013
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 E 149TH ST
BRONX NY
10451-5504
US

IV. Provider business mailing address

150 FRANKLIN ST APARTMENT 1E
NEW YORK NY
10013-2913
US

V. Phone/Fax

Practice location:
  • Phone: 718-579-5000
  • Fax:
Mailing address:
  • Phone: 646-508-9458
  • Fax: 212-431-2415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number096349
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: