Provider Demographics
NPI:1740426725
Name:COUSINS, HILARY (LCSW)
Entity Type:Individual
Prefix:
First Name:HILARY
Middle Name:
Last Name:COUSINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:HILARY
Other - Middle Name:
Other - Last Name:DIEHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:HONESDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18431-1459
Mailing Address - Country:US
Mailing Address - Phone:570-253-8219
Mailing Address - Fax:
Practice Address - Street 1:600 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:HONESDALE
Practice Address - State:PA
Practice Address - Zip Code:18431-1459
Practice Address - Country:US
Practice Address - Phone:570-253-8219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-23
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA391981Medicare Oscar/Certification