Provider Demographics
NPI:1942322235
Name:ST.ONGE, DIANE V (MSW, LADC)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:V
Last Name:ST.ONGE
Suffix:
Gender:F
Credentials:MSW, LADC
Other - Prefix:MRS
Other - First Name:DIANE
Other - Middle Name:V
Other - Last Name:ST.ONGE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LADC
Mailing Address - Street 1:18 BROOKFIELD DR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NH
Mailing Address - Zip Code:03051-5001
Mailing Address - Country:US
Mailing Address - Phone:603-622-4747
Mailing Address - Fax:
Practice Address - Street 1:18 BROOKFIELD DR
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NH
Practice Address - Zip Code:03051-5001
Practice Address - Country:US
Practice Address - Phone:603-622-4747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0392101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH101YAO400XOtherADDICTION COUNSELOR