Provider Demographics
NPI:1780179028
Name:GARNES, DIATHE
Entity type:Individual
Prefix:
First Name:DIATHE
Middle Name:
Last Name:GARNES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1914 BEAVER RD
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23075-2404
Mailing Address - Country:US
Mailing Address - Phone:804-615-8769
Mailing Address - Fax:
Practice Address - Street 1:1914 BEAVER RD
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23075-2404
Practice Address - Country:US
Practice Address - Phone:804-615-8769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-28
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
VA0732001101101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health