Provider Demographics
NPI:1215117460
Name:DIAW, MAIMOUNA (MS, LPCC)
Entity type:Individual
Prefix:
First Name:MAIMOUNA
Middle Name:
Last Name:DIAW
Suffix:
Gender:F
Credentials:MS, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 S CHERRY ST APT 206D
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CO
Mailing Address - Zip Code:80246-2622
Mailing Address - Country:US
Mailing Address - Phone:720-608-8828
Mailing Address - Fax:
Practice Address - Street 1:1008 S CHERRY ST APT 206D
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CO
Practice Address - Zip Code:80246-2622
Practice Address - Country:US
Practice Address - Phone:720-608-8828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-05
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6587101YA0400X
CO0021275101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)