Provider Demographics
NPI:1942358452
Name:HAMMERSLEY, DIANNE S (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DIANNE
Middle Name:S
Last Name:HAMMERSLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DIANNE
Other - Middle Name:S
Other - Last Name:HAMMERSLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:26 STARLIGHT DR
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-3427
Mailing Address - Country:US
Mailing Address - Phone:203-847-0139
Mailing Address - Fax:
Practice Address - Street 1:26 STARLIGHT DRIVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-3427
Practice Address - Country:US
Practice Address - Phone:203-733-0547
Practice Address - Fax:203-847-0139
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT006316101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT396948OtherMHN
CT7044961OtherAETNA
CT140005316CT01OtherANTHEM
CT396948OtherMHN