Forman, Diana M

Forman, Diana M is an individual health care provider with primary practice located at 998 Crooked Hill Rd , Brentwood NY 11717-1019. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Forman, Diana M can be contacted via phone (631) 952-3333.

Contact Information

Primary practice address
998 Crooked Hill Rd Brentwood NY 11717-1019
Phone: (631) 952-3333
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 081646 New York

Profile Details

NPI number 1427420553
LBN Legal business name Forman, Diana M
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 28th, 2015
Last updated Oct 28th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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