Provider Demographics
NPI:1609169838
Name:DIAMOND, HEATHER J (LCSW)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:J
Last Name:DIAMOND
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1719 ROUTE 10
Mailing Address - Street 2:SUITE 129
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-4507
Mailing Address - Country:US
Mailing Address - Phone:973-829-6960
Mailing Address - Fax:973-829-6802
Practice Address - Street 1:1719 ROUTE 10
Practice Address - Street 2:SUITE 129
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-4507
Practice Address - Country:US
Practice Address - Phone:973-829-6960
Practice Address - Fax:973-829-6802
Is Sole Proprietor?:No
Enumeration Date:2011-05-20
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052395001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical