Healthcare Provider Details

I. General information

NPI: 1871613117
Provider Name (Legal Business Name): DIANNA LEE LMSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 E 23RD ST 4TH FLOOR
NEW YORK NY
10010-4516
US

IV. Provider business mailing address

83-33 AUSTIN ST. 3L
KEW GARDENS NY
11415
US

V. Phone/Fax

Practice location:
  • Phone: 212-677-7400
  • Fax: 212-982-5268
Mailing address:
  • Phone: 718-846-0493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number072205
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number022521
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: