1083713499 NPI number — MRS. DIANE EMILY STRADER-WHITNEY LCSW-C

Table of content: MRS. DIANE EMILY STRADER-WHITNEY LCSW-C (NPI 1083713499)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083713499 NPI number — MRS. DIANE EMILY STRADER-WHITNEY LCSW-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STRADER-WHITNEY
Provider First Name:
DIANE
Provider Middle Name:
EMILY
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HOWARD
Provider Other First Name:
DIANE
Provider Other Middle Name:
EMILY
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW-C
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1083713499
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/11/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13852 SPRINGSTONE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLIFTON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
20124-2361
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-830-6176
Provider Business Mailing Address Fax Number:
202-782-4996

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3901 THE ALAMEDA
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21218-2100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-605-7000
Provider Business Practice Location Address Fax Number:
410-605-7685
Provider Enumeration Date:
09/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  12161 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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