Provider Demographics
NPI:1548539497
Name:AMY DIDDEN, LCSW, LLC
Entity type:Organization
Organization Name:AMY DIDDEN, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:DIDDEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:302-231-2312
Mailing Address - Street 1:884 WALKER RD
Mailing Address - Street 2:SUITE 5C
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-2758
Mailing Address - Country:US
Mailing Address - Phone:302-231-2312
Mailing Address - Fax:302-734-7780
Practice Address - Street 1:884 WALKER RD
Practice Address - Street 2:SUITE 5C
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-2758
Practice Address - Country:US
Practice Address - Phone:302-231-2312
Practice Address - Fax:302-734-7780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-0000683261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health