Provider Demographics
NPI:1184227423
Name:SEBZDA, DIANA JEAN (LPC, FT)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:JEAN
Last Name:SEBZDA
Suffix:
Gender:F
Credentials:LPC, FT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 FOX HILL RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:NJ
Mailing Address - Zip Code:07848-3135
Mailing Address - Country:US
Mailing Address - Phone:201-874-4567
Mailing Address - Fax:
Practice Address - Street 1:55 FOX HILL RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:NJ
Practice Address - Zip Code:07848-3135
Practice Address - Country:US
Practice Address - Phone:201-874-4567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00387500101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health