Healthcare Provider Details
I. General information
NPI: 1407174543
Provider Name (Legal Business Name): DIANE E STINSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/13/2010
Last Update Date: 05/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
20 HOSPITAL ROAD BHC OPD WESTCHESTER MEDICAL CENTER
VALHALLA NY
10595
US
IV. Provider business mailing address
PO BOX 831
VERPLANCK NY
10596-0831
US
V. Phone/Fax
- Phone: 914-493-5426
- Fax: 914-493-7089
- Phone: 914-729-4068
- Fax: 914-493-7089
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | R046946 |
| License Number State | NY |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: