Provider Demographics
NPI:1700491743
Name:FOLEY, DIANE EVELYN (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:EVELYN
Last Name:FOLEY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 E LAS OLAS BLVD UNIT 1618
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-2334
Mailing Address - Country:US
Mailing Address - Phone:215-870-5301
Mailing Address - Fax:
Practice Address - Street 1:1314 E LAS OLAS BLVD UNIT 1618
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-2334
Practice Address - Country:US
Practice Address - Phone:215-870-5301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-15
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH19110101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health