Provider Demographics
NPI:1427627421
Name:BABCOCK, DIANNE (MA, LCMHCA, NCC)
Entity type:Individual
Prefix:
First Name:DIANNE
Middle Name:
Last Name:BABCOCK
Suffix:
Gender:F
Credentials:MA, LCMHCA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2721 WHISTLING QUAIL RUN
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-8422
Mailing Address - Country:US
Mailing Address - Phone:919-210-2981
Mailing Address - Fax:
Practice Address - Street 1:1440 ENVIRON WAY FL 4
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-4433
Practice Address - Country:US
Practice Address - Phone:919-636-5240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-23
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA16650101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health