Provider Demographics
NPI:1093828022
Name:SEASONWEIN, DIANA B (MSW)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:B
Last Name:SEASONWEIN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:B
Other - Last Name:SHAPERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:3614 JOCELYN ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-1708
Mailing Address - Country:US
Mailing Address - Phone:202-412-9020
Mailing Address - Fax:202-244-2823
Practice Address - Street 1:5480 WISCONSIN AVE
Practice Address - Street 2:SUITE 222
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-3530
Practice Address - Country:US
Practice Address - Phone:202-412-9020
Practice Address - Fax:202-244-2823
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD020141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD491677Medicare PIN
MD4916577Medicare PIN