Healthcare Provider Details

I. General information

NPI: 1144797762
Provider Name (Legal Business Name): DIANE MARIE OCHALEK LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DIANE MARIE HUBSHMAN

II. Dates (important events)

Enumeration Date: 11/01/2018
Last Update Date: 03/22/2025
Certification Date: 03/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

917 PONTIAC AVE
FREDERICK MD
21701-4638
US

IV. Provider business mailing address

917 PONTIAC AVE
FREDERICK MD
21701-4638
US

V. Phone/Fax

Practice location:
  • Phone: 410-627-0936
  • Fax:
Mailing address:
  • Phone: 410-627-0936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number08157
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: