Provider Demographics
NPI:1376534503
Name:SWEET, DIANE F (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:F
Last Name:SWEET
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 OGDEN AVE
Mailing Address - Street 2:
Mailing Address - City:EAST WILLISTON
Mailing Address - State:NY
Mailing Address - Zip Code:11596-2414
Mailing Address - Country:US
Mailing Address - Phone:516-248-2218
Mailing Address - Fax:516-248-2218
Practice Address - Street 1:26 OGDEN AVE
Practice Address - Street 2:
Practice Address - City:EAST WILLISTON
Practice Address - State:NY
Practice Address - Zip Code:11596-2414
Practice Address - Country:US
Practice Address - Phone:516-248-2218
Practice Address - Fax:516-248-2218
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0291771R1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY094798OtherVALUE OPTIONS
NY7402911OtherGHI
NY7402911OtherGHI