Provider Demographics
NPI:1710095328
Name:DIAMOND, HEDY MARSHA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:HEDY
Middle Name:MARSHA
Last Name:DIAMOND
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:280 1ST AVE
Mailing Address - Street 2:APT 2C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-1835
Mailing Address - Country:US
Mailing Address - Phone:212-677-1243
Mailing Address - Fax:212-677-1243
Practice Address - Street 1:280 FIRST AVE.
Practice Address - Street 2:2C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-1835
Practice Address - Country:US
Practice Address - Phone:212-677-1243
Practice Address - Fax:212-677-1243
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR02989711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN24822Medicare ID - Type Unspecified