Provider Demographics
NPI:1831068907
Name:STEPHENS, DIANNA ANGELICA (LCSW)
Entity type:Individual
Prefix:
First Name:DIANNA
Middle Name:ANGELICA
Last Name:STEPHENS
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 1:600 SUPERIOR AVE STE 1300
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44114-2654
Mailing Address - Country:US
Mailing Address - Phone:646-941-7645
Mailing Address - Fax:929-596-7897
Practice Address - Street 1:600 SUPERIOR AVE STE 1300
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44114-2654
Practice Address - Country:US
Practice Address - Phone:646-941-7645
Practice Address - Fax:929-596-7897
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-05
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.25073041041C0700X
IL149.0302321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical