Provider Demographics
NPI:1962007286
Name:ADAMS, DIANE HANNELORE (LMSW)
Entity type:Individual
Prefix:MS
First Name:DIANE
Middle Name:HANNELORE
Last Name:ADAMS
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:PO BOX 85
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06412-0085
Mailing Address - Country:US
Mailing Address - Phone:860-526-1993
Mailing Address - Fax:
Practice Address - Street 1:67 CEDAR LAKE RD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:CT
Practice Address - Zip Code:06412-1008
Practice Address - Country:US
Practice Address - Phone:860-526-1993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT53841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical