Provider Demographics
NPI:1144797762
Name:OCHALEK, DIANE MARIE (LCSW-C)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:MARIE
Last Name:OCHALEK
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:DIANE
Other - Middle Name:MARIE
Other - Last Name:HUBSHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:316 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-5317
Mailing Address - Country:US
Mailing Address - Phone:410-627-0936
Mailing Address - Fax:
Practice Address - Street 1:316 E 3RD ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-5317
Practice Address - Country:US
Practice Address - Phone:410-627-0936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-01
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD081571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD83-2395300OtherSOLE PROPRIETER