Provider Demographics
NPI:1861661209
Name:DIAMOND, TERESA ANN (MSW , LICSW)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:ANN
Last Name:DIAMOND
Suffix:
Gender:F
Credentials:MSW , LICSW
Other - Prefix:MS
Other - First Name:TYBE
Other - Middle Name:ANN
Other - Last Name:DIAMOND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW , LICSW
Mailing Address - Street 1:4707 CONNECTICUT AVE NW
Mailing Address - Street 2:STE. 205
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-5631
Mailing Address - Country:US
Mailing Address - Phone:202-966-1381
Mailing Address - Fax:202-338-3363
Practice Address - Street 1:4707 CONNECTICUT AVE NW
Practice Address - Street 2:STE. 205
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-5631
Practice Address - Country:US
Practice Address - Phone:202-966-1381
Practice Address - Fax:202-338-3363
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3014551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical