Provider Demographics
NPI:1174043970
Name:STROM PINCUS, DIANE (LCSWR)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:STROM PINCUS
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:DIANE
Other - Middle Name:
Other - Last Name:PINCUS-STROM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:1650 SELWYN AVE APT 8E
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-7627
Mailing Address - Country:US
Mailing Address - Phone:718-960-1020
Mailing Address - Fax:
Practice Address - Street 1:1650 SELWYN AVE APT 8E
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-7627
Practice Address - Country:US
Practice Address - Phone:718-960-1020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0187041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical