Provider Demographics
NPI:1215665781
Name:DIAZ, EKATERINA MARIA (LMSW)
Entity type:Individual
Prefix:MISS
First Name:EKATERINA
Middle Name:MARIA
Last Name:DIAZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3840 LISA CT UNIT D
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-1130
Mailing Address - Country:US
Mailing Address - Phone:775-233-8233
Mailing Address - Fax:
Practice Address - Street 1:850 MILL ST STE 100
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1463
Practice Address - Country:US
Practice Address - Phone:775-538-6700
Practice Address - Fax:775-688-5878
Is Sole Proprietor?:No
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10048-M104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker