Provider Demographics
NPI:1659542413
Name:HOPE, DIANA (LMSW, CASAC)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:HOPE
Suffix:
Gender:F
Credentials:LMSW, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2488 GRAND CONCOURSE FL 4
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-5203
Mailing Address - Country:US
Mailing Address - Phone:718-584-7204
Mailing Address - Fax:718-584-8394
Practice Address - Street 1:40 MACON ST
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-3238
Practice Address - Country:US
Practice Address - Phone:770-495-0179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-19
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY076762104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker