Provider Demographics
NPI:1023053162
Name:DIAMOND-RAAB, LISA MARIAN (MA, LPC, ATR, CP)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:MARIAN
Last Name:DIAMOND-RAAB
Suffix:
Gender:F
Credentials:MA, LPC, ATR, CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 MASSACHUSETTS AVE NW
Mailing Address - Street 2:SUITE 111
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-4358
Mailing Address - Country:US
Mailing Address - Phone:202-244-6989
Mailing Address - Fax:301-320-6369
Practice Address - Street 1:4900 MASSACHUSETTS AVE NW
Practice Address - Street 2:SUITE 111
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-4358
Practice Address - Country:US
Practice Address - Phone:202-244-6989
Practice Address - Fax:301-320-6369
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC1117101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional