Provider Demographics
NPI:1730224346
Name:BARNES, DIANE MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:MARIE
Last Name:BARNES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 STATE ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-1853
Mailing Address - Country:US
Mailing Address - Phone:212-995-5673
Mailing Address - Fax:212-587-7619
Practice Address - Street 1:276 5TH AVE
Practice Address - Street 2:SUITE 307A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-4509
Practice Address - Country:US
Practice Address - Phone:212-587-7618
Practice Address - Fax:212-587-7619
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR044135-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical