Provider Demographics
NPI:1376615062
Name:CROSBY, DIANE E (MSW)
Entity Type:Individual
Prefix:MISS
First Name:DIANE
Middle Name:E
Last Name:CROSBY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1244
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:NH
Mailing Address - Zip Code:03086-1244
Mailing Address - Country:US
Mailing Address - Phone:603-654-5665
Mailing Address - Fax:
Practice Address - Street 1:113 PUTNAM HILL RD
Practice Address - Street 2:
Practice Address - City:LYNDEBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03082-6135
Practice Address - Country:US
Practice Address - Phone:603-654-5665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical