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MRS. KAITLIN DIAZ MSW, LSW
NPI 1639794514
Social Worker in Mahwah, NJ

Active since June 16, 2020PECOS Enrolled
860 WYCKOFF AVE STE 206, MAHWAH, NJ 07430(551) 319-2029 Get Directions Write a Review

NPPES record last updated: October 26, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mrs. Kaitlin Diaz Msw, Lsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. KAITLIN DIAZ MSW, LSW (NPI 1639794514) is an individual social worker in Mahwah, New Jersey, licensed in New Jersey (44SL05812100) and active in the NPI registry since June 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2012).

NPPES Registry Identity

NPI1639794514
Entity TypeIndividualFemale
Primary Taxonomy104100000X
Provider Legal NameMRS. KAITLIN DIAZCredential: MSW, LSW
Location Address860 WYCKOFF AVE STE 206Mahwah, NJ 07430-3186
Mailing Address529 E Saddle River RdUpper Saddle River, NJ 07458-1309 · (201) 519-2531
Phone(551) 319-2029
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateJune 16, 2020
Last NPPES UpdateOctober 26, 2021
NPPES CertifiedOctober 26, 2021
✔ NPI 1639794514 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers
Taxonomy Code104100000X
License✔ Licensed in NJ · 44SL05812100
Definition
A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.
860 WYCKOFF AVE STE 206, Mahwah, NJ 07430
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Kaitlin Diaz Msw, Lsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4385104090
PECOS Enrollment IDI20260902000239
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kaitlin Diaz reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Community Health Resources, Inc.
95 mi
Mental Health (Including Community Mental Health Center)
2 WATERSIDE XING STE 401
Windsor, CT 06095
  • Reassigned Medicare billing, Connecticut enrollment
  • 227 clinicians in this Medicare group
NPI 1215979810 (860) 731-5522

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BEAUTIFUL JOURNEY COUNSELING
Counselor (Mental Health)
860 WYCKOFF AVE STE 206
MAHWAH, NJ 07430
Bergen County (551) 319-2029
HANNAH DONNER MED
Counselor (Mental Health)
860 WYCKOFF AVE STE 206
MAHWAH, NJ 07430
Bergen County (551) 319-2029
SHARON GBADAMOSI LAC
Counselor (Mental Health)
860 WYCKOFF AVE STE 206
MAHWAH, NJ 07430
Bergen County (551) 315-3674
KIMBERLY PEREZ-LUCERO
Counselor
860 WYCKOFF AVE STE 206
MAHWAH, NJ 07430
Bergen County (551) 319-2029
DR. SAMANTHA HERRICK PHD
Counselor (Mental Health)
860 WYCKOFF AVE STE 206
MAHWAH, NJ 07430
Bergen County (551) 319-2029
STEPHANIE ABATAYO LSW
Social Worker
860 WYCKOFF AVE STE 206
MAHWAH, NJ 07430
Bergen County (551) 319-2029

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kaitlin Diaz's NPI number?

The NPI number for Kaitlin Diaz is 1639794514. It was assigned to this individual provider in the NPPES registry on June 16, 2020.

Where is Kaitlin Diaz located?

Kaitlin Diaz practices at 860 Wyckoff Ave Ste 206, Mahwah, NJ 07430. The listed phone number is (551) 319-2029.

What is Kaitlin Diaz's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Is Kaitlin Diaz enrolled in Medicare?

Yes. Kaitlin Diaz is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kaitlin Diaz's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kaitlin Diaz reassigns Medicare benefits to Community Health Resources, Inc. (Windsor, CT). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kaitlin Diaz's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kaitlin Diaz was last updated on October 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.