Provider Demographics
NPI:1366879736
Name:PROPERT, DIANE (LPC)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:PROPERT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2329 HIGHWAY 34
Mailing Address - Street 2:
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-1442
Mailing Address - Country:US
Mailing Address - Phone:732-223-9355
Mailing Address - Fax:
Practice Address - Street 1:2329 HIGHWAY 34
Practice Address - Street 2:
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-1442
Practice Address - Country:US
Practice Address - Phone:732-223-9355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-01
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC000205000101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional