Provider Demographics
NPI:1730261553
Name:STEENSTRA, DIANE L (MS)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:L
Last Name:STEENSTRA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:DIANE
Other - Middle Name:LYNN
Other - Last Name:YOUNGSMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:118 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1677
Mailing Address - Country:US
Mailing Address - Phone:717-231-8539
Mailing Address - Fax:717-231-8588
Practice Address - Street 1:205 S FRONT ST
Practice Address - Street 2:5TH FLOOR
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17104-1619
Practice Address - Country:US
Practice Address - Phone:717-231-8360
Practice Address - Fax:717-231-8358
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004147101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA232007907OtherTRICARE
PA222394OtherUNISON
PW50070965OtherBLUE CROSS
PA1007446410021Medicaid