Provider Demographics
NPI:1164475273
Name:HAMBROOK, DIANE J (LCSW-R)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:J
Last Name:HAMBROOK
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 CLINTON AVE
Mailing Address - Street 2:APT. 11A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205-3572
Mailing Address - Country:US
Mailing Address - Phone:718-596-1676
Mailing Address - Fax:
Practice Address - Street 1:40 FLATBUSH AVE
Practice Address - Street 2:8TH FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-1121
Practice Address - Country:US
Practice Address - Phone:718-439-4338
Practice Address - Fax:718-439-4340
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0492821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical