Provider Demographics
NPI:1437792660
Name:POEHLMAN, DIANE CHRISTINE (LMHC)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:CHRISTINE
Last Name:POEHLMAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5066 KARRIKER CT # 0
Mailing Address - Street 2:
Mailing Address - City:INDIAN LAND
Mailing Address - State:SC
Mailing Address - Zip Code:29707-7482
Mailing Address - Country:US
Mailing Address - Phone:561-704-6961
Mailing Address - Fax:
Practice Address - Street 1:5066 KARRIKER CT # 0
Practice Address - Street 2:
Practice Address - City:INDIAN LAND
Practice Address - State:SC
Practice Address - Zip Code:29707-7482
Practice Address - Country:US
Practice Address - Phone:561-704-6961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH5868101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional