Provider Demographics
NPI:1316400666
Name:DIAZ, KAMI (LCSW-S)
Entity Type:Individual
Prefix:MS
First Name:KAMI
Middle Name:
Last Name:DIAZ
Suffix:
Gender:F
Credentials:LCSW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451D E CENTEX EXPWY
Mailing Address - Street 2:304
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548
Mailing Address - Country:US
Mailing Address - Phone:254-392-0118
Mailing Address - Fax:
Practice Address - Street 1:2710 CUNNINGHAM RD UNIT 21104
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-3270
Practice Address - Country:US
Practice Address - Phone:254-217-1982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-12
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX397841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical