Provider Demographics
NPI:1134304835
Name:AKERET, DIANA L (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DIANA
Middle Name:L
Last Name:AKERET
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:PO BOX 123
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-0123
Mailing Address - Country:US
Mailing Address - Phone:609-675-6907
Mailing Address - Fax:844-657-9591
Practice Address - Street 1:359 96TH ST
Practice Address - Street 2:SUITE 302
Practice Address - City:STONE HARBOR
Practice Address - State:NJ
Practice Address - Zip Code:08247-1409
Practice Address - Country:US
Practice Address - Phone:609-675-6907
Practice Address - Fax:844-657-9591
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-02
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052792001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
532115Medicare PIN