Provider Demographics
NPI:1982231858
Name:PACHE, DIANA DEASEN (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:DEASEN
Last Name:PACHE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 ELTON AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-4520
Mailing Address - Country:US
Mailing Address - Phone:646-659-4393
Mailing Address - Fax:
Practice Address - Street 1:818 ELTON AVE APT 2
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-4520
Practice Address - Country:US
Practice Address - Phone:646-659-4393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-23
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker