Provider Demographics
NPI:1306282843
Name:DIAZ, ZORAIDA (LCSW, CASAC)
Entity type:Individual
Prefix:MS
First Name:ZORAIDA
Middle Name:
Last Name:DIAZ
Suffix:
Gender:F
Credentials:LCSW, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84-13 106 AVE.
Mailing Address - Street 2:
Mailing Address - City:OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11417
Mailing Address - Country:US
Mailing Address - Phone:718-835-3267
Mailing Address - Fax:718-670-8847
Practice Address - Street 1:146 -01 45 AVE.
Practice Address - Street 2:# 205
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355
Practice Address - Country:US
Practice Address - Phone:718-670-5078
Practice Address - Fax:718-670-8847
Is Sole Proprietor?:No
Enumeration Date:2013-05-10
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY087939104100000X
NY0858291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker