Provider Demographics
NPI:1922667716
Name:MCNAMARA, DIANA (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:DIANA
Middle Name:
Last Name:MCNAMARA
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:MS
Other - First Name:DIANE
Other - Middle Name:
Other - Last Name:CURASI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13 AUDREY LANE
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725
Mailing Address - Country:US
Mailing Address - Phone:631-988-2593
Mailing Address - Fax:
Practice Address - Street 1:13 AUDREY LANE
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725
Practice Address - Country:US
Practice Address - Phone:631-988-2593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-06
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR055909-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty