Provider Demographics
NPI:1407071673
Name:DIANE STANLEY LCSW LLC
Entity Type:Organization
Organization Name:DIANE STANLEY LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:STANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:908-334-7206
Mailing Address - Street 1:22 TRENT RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-1974
Mailing Address - Country:US
Mailing Address - Phone:908-334-7206
Mailing Address - Fax:888-974-1397
Practice Address - Street 1:20 COMMERCE DR STE 135
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-3614
Practice Address - Country:US
Practice Address - Phone:908-334-7206
Practice Address - Fax:888-974-1397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-14
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJLCSW 44SC04782100261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)