Provider Demographics
NPI:1316080948
Name:KING, DIANE I (LCSW)
Entity type:Individual
Prefix:MS
First Name:DIANE
Middle Name:I
Last Name:KING
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Gender:F
Credentials:LCSW
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Mailing Address - Street 1:14454 SANFORD AVE
Mailing Address - Street 2:APT.. 47
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-1680
Mailing Address - Country:US
Mailing Address - Phone:718-359-8783
Mailing Address - Fax:718-359-8783
Practice Address - Street 1:51 E 25TH ST
Practice Address - Street 2:SUITE 7B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-2945
Practice Address - Country:US
Practice Address - Phone:718-359-8783
Practice Address - Fax:718-359-8783
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2014-09-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYPR004544-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical