Provider Demographics
NPI:1922255066
Name:KAY-DAIGLE, DIANE E (LCSW)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:E
Last Name:KAY-DAIGLE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DIANE
Other - Middle Name:E
Other - Last Name:KAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 1126
Mailing Address - Street 2:
Mailing Address - City:SOUTHWEST HARBOR
Mailing Address - State:ME
Mailing Address - Zip Code:04679-1126
Mailing Address - Country:US
Mailing Address - Phone:207-292-3511
Mailing Address - Fax:
Practice Address - Street 1:8 BETHANY LN
Practice Address - Street 2:
Practice Address - City:BAR HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04609-6010
Practice Address - Country:US
Practice Address - Phone:207-292-3511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-20
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC126761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME12676OtherLCSW LICENCE
ME432831199Medicaid