Provider Demographics
NPI:1033166319
Name:KESSELER, DIANE M (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:M
Last Name:KESSELER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6230 BILLINSGATE DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-8448
Mailing Address - Country:US
Mailing Address - Phone:281-795-3598
Mailing Address - Fax:
Practice Address - Street 1:6230 BILLINSGATE DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-8448
Practice Address - Country:US
Practice Address - Phone:281-795-3598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-30
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX154051041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8D3030Medicare PIN