Healthcare Provider Details

I. General information

NPI: 1033259577
Provider Name (Legal Business Name): DIANE OKONESKI LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5480 WISCONSIN AVE LOWR LEVEL-8
CHEVY CHASE MD
20815-3530
US

IV. Provider business mailing address

PO BOX 3646
SILVER SPRING MD
20918-3646
US

V. Phone/Fax

Practice location:
  • Phone: 301-593-1618
  • Fax:
Mailing address:
  • Phone: 301-593-1618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number05409
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: