Provider Demographics
NPI:1295025849
Name:DIDDEN, AMY ELLEN (LCSW)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:ELLEN
Last Name:DIDDEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:ELLEN
Other - Last Name:CHEEVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:884 WALKER RD
Mailing Address - Street 2:SUITE 5C
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-2758
Mailing Address - Country:US
Mailing Address - Phone:302-231-2312
Mailing Address - Fax:302-734-7780
Practice Address - Street 1:884 WALKER RD
Practice Address - Street 2:SUITE 5C
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-2758
Practice Address - Country:US
Practice Address - Phone:302-231-2312
Practice Address - Fax:302-734-7780
Is Sole Proprietor?:No
Enumeration Date:2011-04-17
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00006831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical