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General NPI Number Information
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NPI Number | 1316080948
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Entity Type | Individual
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Provider Name | DIANE I KING LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 09/24/2014
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Provider Practice Location Address
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Address Line | 51 E 25TH ST SUITE 7B
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City | NEW YORK
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State | NY
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Zip | 10010-2945
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Country | US
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Telephone | 718-359-8783
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Fax | 718-359-8783
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Provider Business Mailing Address
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Address Line | 14454 SANFORD AVE APT.. 47
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City | FLUSHING
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State | NY
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Zip | 11355-1680
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Country | US
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Telephone | 718-359-8783
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Fax | 718-359-8783
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | PR004544-1
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License Number State | NY
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