Provider Demographics
NPI:1134422025
Name:CASE, DIANNA LYNN (LCSW)
Entity type:Individual
Prefix:MS
First Name:DIANNA
Middle Name:LYNN
Last Name:CASE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2011 SADDLEGATE CT
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-5803
Mailing Address - Country:US
Mailing Address - Phone:337-337-5469
Mailing Address - Fax:336-217-8763
Practice Address - Street 1:430 BATTLEGROUND AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-2104
Practice Address - Country:US
Practice Address - Phone:336-337-5469
Practice Address - Fax:336-217-8763
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-14
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0070931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6007767Medicaid