Healthcare Provider Details

I. General information

NPI: 1225092174
Provider Name (Legal Business Name): DIANE LIGHT SPIRO LCSW-R
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DIANE LIGHT-SPIRO LCSWR

II. Dates (important events)

Enumeration Date: 04/16/2006
Last Update Date: 09/01/2025
Certification Date: 09/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 ACADEMY ST APT 9B
POUGHKEEPSIE NY
12601-4597
US

IV. Provider business mailing address

160 ACADEMY ST APT 9B
POUGHKEEPSIE NY
12601-4597
US

V. Phone/Fax

Practice location:
  • Phone: 914-474-8659
  • Fax:
Mailing address:
  • Phone: 914-474-8659
  • Fax: 888-972-5017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR043943-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: