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1861661209 NPI number — TERESA ANN DIAMOND M.S.W. , L.I.C.S.W.

NPI Number: 1861661209
Health Care Provider/Practitioner: TERESA ANN DIAMOND M.S.W. , L.I.C.S.W.

Information about “1861661209” NPI (TERESA ANN DIAMOND M.S.W. , L.I.C.S.W.) exists in 1861661209 in HTML format HTML  |  1861661209 in plain Text format TXT  |  1861661209 in PDF (Portable Document Format) PDF  |  1861661209 in an XML format XML  formats.

NPI Number : 1861661209 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1861661209",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DIAMOND",
    "FirstName": "TERESA",
    "MiddleName": "ANN",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "M.S.W. ,  L.I.C.S.W.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "DIAMOND",
    "OtherFirstName": "TYBE",
    "OtherMiddleName": "ANN",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "M.S.W. ,  L.I.C.S.W.",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "4707 CONNECTICUT AVE NW",
    "SecondLineMailingAddress": "STE. 205",
    "MailingAddressCityName": "WASHINGTON",
    "MailingAddressStateName": "DC",
    "MailingAddressPostalCode": "20008-5631",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "202-966-1381",
    "MailingAddressFaxNumber": "202-338-3363",
    "FirstLinePracticeLocationAddress": "4707 CONNECTICUT AVE NW",
    "SecondLinePracticeLocationAddress": "STE. 205",
    "PracticeLocationAddressCityName": "WASHINGTON",
    "PracticeLocationAddressStateName": "DC",
    "PracticeLocationAddressPostalCode": "20008-5631",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "202-966-1381",
    "PracticeLocationAddressFaxNumber": "202-338-3363",
    "EnumerationDate": "02/29/2008",
    "LastUpdateDate": "02/29/2008",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1041C0700X",
        "TaxonomyName": "Clinical Social Worker",
        "LicenseNumber": "LC301455",
        "LicenseNumberStateCode": "DC",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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