=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437299948
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DIANE APPLEBAUM ADLER LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/07/2007
-----------------------------------------------------
Last Update Date | 09/24/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 123 WEST 79TH ST PENTHOUSE 1
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10024-6485
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-580-2914
-----------------------------------------------------
Fax | 609-924-9272
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 187 SAPPHIRE LANE FRANKLIN PARK
-----------------------------------------------------
City | NEW JERSEY
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08823-1648
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-580-2914
-----------------------------------------------------
Fax | 609-924-9272
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 44SC00151100
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | PR0175271
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------