Provider Demographics
NPI:1396900262
Name:WEBB, DIANE ELIZABETH (LMHC)
Entity type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:ELIZABETH
Last Name:WEBB
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MS
Other - First Name:DIANE
Other - Middle Name:ELIZABETH
Other - Last Name:GRIMALDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2607 SYLVAN LOOP
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-7078
Mailing Address - Country:US
Mailing Address - Phone:845-545-9244
Mailing Address - Fax:
Practice Address - Street 1:372 FULLERTON AVE
Practice Address - Street 2:RM 17
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-3744
Practice Address - Country:US
Practice Address - Phone:845-545-9244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-21
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005731101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health