Provider Demographics
NPI:1174703201
Name:JAMES, DIANA LYN (MA, LCPC, LMFT)
Entity type:Individual
Prefix:MS
First Name:DIANA
Middle Name:LYN
Last Name:JAMES
Suffix:
Gender:F
Credentials:MA, LCPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 COVE POINT RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04576-3051
Mailing Address - Country:US
Mailing Address - Phone:207-633-2267
Mailing Address - Fax:
Practice Address - Street 1:428 RTE 1
Practice Address - Street 2:
Practice Address - City:EDGECOMB
Practice Address - State:ME
Practice Address - Zip Code:04455
Practice Address - Country:US
Practice Address - Phone:207-882-6700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMF1981 AND CC2148101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health