Provider Demographics
NPI:1437299948
Name:ADLER, DIANE APPLEBAUM (LCSW)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:APPLEBAUM
Last Name:ADLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DIANE
Other - Middle Name:
Other - Last Name:APPLEBAUM ADLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:187 SAPPHIRE LANE
Mailing Address - Street 2:FRANKLIN PARK
Mailing Address - City:NEW JERSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:08823-1648
Mailing Address - Country:US
Mailing Address - Phone:212-580-2914
Mailing Address - Fax:609-924-9272
Practice Address - Street 1:123 WEST 79TH ST
Practice Address - Street 2:PENTHOUSE 1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6485
Practice Address - Country:US
Practice Address - Phone:212-580-2914
Practice Address - Fax:609-924-9272
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC001511001041C0700X
NYPR01752711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
N16591Medicare ID - Type Unspecified