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General NPI Number Information
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NPI Number | 1063015873
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Entity Type | Organization
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Legal Business Name | DIAON CLARKE LCSW LLC
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Dates
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Enumeration Date | 11/16/2020
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 6 GRAMATAN AVE STE 607
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City | MOUNT VERNON
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State | NY
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Zip | 10550-3208
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Country | US
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Telephone | 914-837-8336
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Fax | 914-560-2135
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Provider Business Mailing Address
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Address Line | 3B ROSMAN RD
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City | THIELLS
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State | NY
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Zip | 10984-1627
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Country | US
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Telephone | 914-837-8336
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Fax | 914-560-2135
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Authorized Official
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Title or Position | OWNER
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Name | DR. DIAON M CLARKE
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Credential | PHD
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Telephone | 914-837-8336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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