Provider Demographics
NPI:1831492107
Name:ZEITLIN, DIANE CAROL (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:CAROL
Last Name:ZEITLIN
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 1:48 W 74TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-2401
Mailing Address - Country:US
Mailing Address - Phone:212-721-8888
Mailing Address - Fax:212-721-1547
Practice Address - Street 1:48 W 74TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-2401
Practice Address - Country:US
Practice Address - Phone:212-721-8888
Practice Address - Fax:212-721-1547
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-08
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY077104-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical