Provider Demographics
NPI:1952036436
Name:CROWN, DIANE ELLEN (LSW, MSW, MBA, PCHA)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:ELLEN
Last Name:CROWN
Suffix:
Gender:F
Credentials:LSW, MSW, MBA, PCHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1636 PINE ST
Mailing Address - Street 2:
Mailing Address - City:HATFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19440-3340
Mailing Address - Country:US
Mailing Address - Phone:215-285-3991
Mailing Address - Fax:
Practice Address - Street 1:5201 ST. JOSEPH'S ROAD
Practice Address - Street 2:
Practice Address - City:LIMEPORT
Practice Address - State:PA
Practice Address - Zip Code:18060
Practice Address - Country:US
Practice Address - Phone:610-928-5277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
PASW010704L104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker