Provider Demographics
NPI:1699267849
Name:COMISKEY, DIANA LUCIA (LPC, LMHC, NCC)
Entity type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:LUCIA
Last Name:COMISKEY
Suffix:
Gender:F
Credentials:LPC, LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1568 NW 171ST AVE
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1361
Mailing Address - Country:US
Mailing Address - Phone:954-913-7708
Mailing Address - Fax:
Practice Address - Street 1:1400 NW 14TH CT
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33311-5426
Practice Address - Country:US
Practice Address - Phone:754-321-1590
Practice Address - Fax:754-321-1688
Is Sole Proprietor?:No
Enumeration Date:2018-06-04
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701007654101YP2500X
FLMH17333101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional