Provider Demographics
NPI:1386361269
Name:HOWARD, DIANA MICHELLE (LMSW)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:MICHELLE
Last Name:HOWARD
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 1:283 W 147TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10039-3410
Mailing Address - Country:US
Mailing Address - Phone:847-664-9466
Mailing Address - Fax:
Practice Address - Street 1:283 W 147TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10039-3410
Practice Address - Country:US
Practice Address - Phone:847-664-9466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-21
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY115406-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker