Provider Demographics
NPI:1730931437
Name:HAYWOOD, DIAMOND LYNETTE' (LCSWA)
Entity type:Individual
Prefix:
First Name:DIAMOND
Middle Name:LYNETTE'
Last Name:HAYWOOD
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4502 STAFFORDSHIRE DR APT 12
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-0932
Mailing Address - Country:US
Mailing Address - Phone:252-673-3244
Mailing Address - Fax:
Practice Address - Street 1:2719 GRAVES DR STE 5
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-4536
Practice Address - Country:US
Practice Address - Phone:919-330-4367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0202761041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker