Provider Demographics
NPI:1033753769
Name:DIBA, ARASH (LMSW)
Entity Type:Individual
Prefix:
First Name:ARASH
Middle Name:
Last Name:DIBA
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:743 E 9TH ST # 749
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-5335
Mailing Address - Country:US
Mailing Address - Phone:212-677-7999
Mailing Address - Fax:
Practice Address - Street 1:743 E 9TH ST # 749
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-5335
Practice Address - Country:US
Practice Address - Phone:212-677-7999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-06
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY107240104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker