Healthcare Provider Details

I. General information

NPI: 1083713499
Provider Name (Legal Business Name): DIANE EMILY STRADER-WHITNEY LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DIANE EMILY HOWARD LCSW-C

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 02/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 THE ALAMEDA
BALTIMORE MD
21218-2100
US

IV. Provider business mailing address

13852 SPRINGSTONE DR
CLIFTON VA
20124-2361
US

V. Phone/Fax

Practice location:
  • Phone: 410-605-7000
  • Fax: 410-605-7685
Mailing address:
  • Phone: 703-830-6176
  • Fax: 202-782-4996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number12161
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: