Provider Demographics
NPI:1497060800
Name:MEAD, DIANNE BEDNARIK (LCSWR)
Entity Type:Individual
Prefix:MRS
First Name:DIANNE
Middle Name:BEDNARIK
Last Name:MEAD
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BRYANT CRES APT 1LK
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-2637
Mailing Address - Country:US
Mailing Address - Phone:914-715-4439
Mailing Address - Fax:
Practice Address - Street 1:1 BRYANT CRES APT 1LK
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-2637
Practice Address - Country:US
Practice Address - Phone:914-715-4439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-10
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0726511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical