Healthcare Provider Details

I. General information

NPI: 1275296618
Provider Name (Legal Business Name): MATTHEW DIAMOND LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2021
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

481 MAIN ST
NEW ROCHELLE NY
10801-6324
US

IV. Provider business mailing address

481 MAIN ST
NEW ROCHELLE NY
10801-6324
US

V. Phone/Fax

Practice location:
  • Phone: 914-355-2440
  • Fax:
Mailing address:
  • Phone: 914-355-2440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number101235
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number5953
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: