Provider Demographics
NPI:1881284727
Name:HORNSTEIN, DIANE (LPC)
Entity type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:
Last Name:HORNSTEIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11337 QUIGLEY LN
Mailing Address - Street 2:
Mailing Address - City:CONNEAUT LAKE
Mailing Address - State:PA
Mailing Address - Zip Code:16316-3747
Mailing Address - Country:US
Mailing Address - Phone:814-282-3097
Mailing Address - Fax:
Practice Address - Street 1:15957 CONNEAUT LAKE RD STE 8
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-4763
Practice Address - Country:US
Practice Address - Phone:814-807-1330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC012016101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty