Provider Demographics
NPI:1972650919
Name:DIAKON LUTHERAN SOCIAL MINISTRIES
Entity Type:Organization
Organization Name:DIAKON LUTHERAN SOCIAL MINISTRIES
Other - Org Name:BRANDYWINE PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:FERN
Authorized Official - Middle Name:A
Authorized Official - Last Name:SPELLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:302-995-2002
Mailing Address - Street 1:240 N JAMES ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NEWPORT
Mailing Address - State:DE
Mailing Address - Zip Code:19804-3169
Mailing Address - Country:US
Mailing Address - Phone:302-995-2002
Mailing Address - Fax:302-995-2121
Practice Address - Street 1:240 N JAMES ST
Practice Address - Street 2:SUITE 200
Practice Address - City:NEWPORT
Practice Address - State:DE
Practice Address - Zip Code:19804-3169
Practice Address - Country:US
Practice Address - Phone:302-995-2002
Practice Address - Fax:302-995-2121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health