Provider Demographics
NPI:1396932018
Name:STANTON, DIANA MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:MARIE
Last Name:STANTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:483 VAN WYCK LAKE RD
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-6404
Mailing Address - Country:US
Mailing Address - Phone:845-797-5357
Mailing Address - Fax:
Practice Address - Street 1:1285 ROUTE 9 STE 7
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-4993
Practice Address - Country:US
Practice Address - Phone:845-797-5357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-26
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY080863101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional