Provider Demographics
NPI:1841877909
Name:DIAMOND, CECIL FRANKLIN LEE
Entity type:Individual
Prefix:
First Name:CECIL
Middle Name:FRANKLIN LEE
Last Name:DIAMOND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4625 WV-152
Mailing Address - Street 2:
Mailing Address - City:LAVALETTE
Mailing Address - State:WV
Mailing Address - Zip Code:25535
Mailing Address - Country:US
Mailing Address - Phone:304-308-6074
Mailing Address - Fax:
Practice Address - Street 1:4625 WV-152
Practice Address - Street 2:
Practice Address - City:LAVALETTE
Practice Address - State:WV
Practice Address - Zip Code:25535
Practice Address - Country:US
Practice Address - Phone:304-308-6074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-25
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker