Provider Demographics
NPI:1194000356
Name:HALBRITTER, DIANE A (MSW)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:A
Last Name:HALBRITTER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 HIGH ST STE 218
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-5446
Mailing Address - Country:US
Mailing Address - Phone:304-376-0080
Mailing Address - Fax:
Practice Address - Street 1:235 HIGH ST STE 218
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-5446
Practice Address - Country:US
Practice Address - Phone:304-376-0080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVDP009423071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical