Provider Demographics
NPI:1093251639
Name:SEROPIAN, DIANA (LCSW)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:SEROPIAN
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 1:3851 PIPER ST # 264
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4684
Mailing Address - Country:US
Mailing Address - Phone:907-562-4673
Mailing Address - Fax:
Practice Address - Street 1:3851 PIPER ST # 264
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4684
Practice Address - Country:US
Practice Address - Phone:907-562-4673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-06
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK391101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health