Provider Demographics
NPI:1033724489
Name:SCHWERDT, DIANE COSTELLO (LICSW)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:COSTELLO
Last Name:SCHWERDT
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 ARMEN WAY
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-1900
Mailing Address - Country:US
Mailing Address - Phone:617-957-4279
Mailing Address - Fax:
Practice Address - Street 1:145 ROSEMARY ST UNIT K
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494-3238
Practice Address - Country:US
Practice Address - Phone:617-444-7186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-12
Last Update Date:2020-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1229511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical