Provider Demographics
NPI:1700192622
Name:ARKAVA, DIANE L (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:L
Last Name:ARKAVA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 HICKORY ST STE A
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-1820
Mailing Address - Country:US
Mailing Address - Phone:406-671-0821
Mailing Address - Fax:
Practice Address - Street 1:712 W SPRUCE ST STE 4
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4029
Practice Address - Country:US
Practice Address - Phone:406-671-0821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-30
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT9481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical