Provider Demographics
NPI:1932286440
Name:DIAMANTE-KOCH, JANET (MSW ,LCSWR)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:DIAMANTE-KOCH
Suffix:
Gender:F
Credentials:MSW ,LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 MOUNT ZION RD
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NY
Mailing Address - Zip Code:12542-5021
Mailing Address - Country:US
Mailing Address - Phone:844-562-4229
Mailing Address - Fax:
Practice Address - Street 1:346 MOUNT ZION RD
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:NY
Practice Address - Zip Code:12542-5021
Practice Address - Country:US
Practice Address - Phone:844-562-4229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0476471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical