Provider Demographics
NPI:1366708307
Name:NUKK, DIANNE SEARS (LCSW)
Entity type:Individual
Prefix:MS
First Name:DIANNE
Middle Name:SEARS
Last Name:NUKK
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 1:19 SPEAR ROAD-SUITE 201
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-1223
Mailing Address - Country:US
Mailing Address - Phone:201-978-9668
Mailing Address - Fax:201-825-7550
Practice Address - Street 1:19 SPEAR ROAD
Practice Address - Street 2:SUITE 201
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-1223
Practice Address - Country:US
Practice Address - Phone:201-978-9668
Practice Address - Fax:201-825-7550
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC00745800104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker