Provider Demographics
NPI:1841443629
Name:KANCZES, DIANE (LSW)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:KANCZES
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 NORTHGATE SQ
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-1341
Mailing Address - Country:US
Mailing Address - Phone:724-832-0947
Mailing Address - Fax:
Practice Address - Street 1:1 NORTHGATE SQ
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-1341
Practice Address - Country:US
Practice Address - Phone:724-832-0947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW011364L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical