Provider Demographics
NPI:1003466814
Name:DIANE MARSIN FURST, LCSW,PLLC
Entity Type:Organization
Organization Name:DIANE MARSIN FURST, LCSW,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:MARSIN-FURST
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:845-294-1635
Mailing Address - Street 1:25 MAIN ST STE 2.2
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-2144
Mailing Address - Country:US
Mailing Address - Phone:845-294-6151
Mailing Address - Fax:845-258-4611
Practice Address - Street 1:25 MAIN ST STE 2.2
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-2144
Practice Address - Country:US
Practice Address - Phone:845-294-1635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-13
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty