Provider Demographics
NPI:1801310107
Name:CHIN, DIANE K (LCSWC)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:K
Last Name:CHIN
Suffix:
Gender:F
Credentials:LCSWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 FORBES BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-4877
Mailing Address - Country:US
Mailing Address - Phone:301-306-4590
Mailing Address - Fax:301-306-4591
Practice Address - Street 1:4601 FORBES BLVD STE 100
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-4877
Practice Address - Country:US
Practice Address - Phone:301-306-4590
Practice Address - Fax:301-306-4591
Is Sole Proprietor?:No
Enumeration Date:2017-07-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD088141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical