Anderson, Diana Kay

Anderson, Diana Kay is an individual health care provider with primary practice located at 3020 W Willow Knolls Dr , Peoria IL 61614-8127. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Anderson, Diana Kay can be contacted via phone (309) 681-5652.

Contact Information

Primary practice address
3020 W Willow Knolls Dr Peoria IL 61614-8127
Phone: (309) 681-5652
Fax: (309) 681-5658
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 150.009965 Illinois
Behavioral Health & Social Service Providers / Social Worker 104100000X 150.009965 Illinois
Behavioral Health & Social Service Providers / Clinical 1041C0700X 149012844 Illinois

Profile Details

NPI number 1619190006
LBN Legal business name Anderson, Diana Kay
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 11th, 2007
Last updated Jun 10th, 2024 - about 6 months 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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Identifiers

StateTypeNumberIssuer
All States NPI 1619190006 NPPES
Illinois Other 150.009965 DPR LICENSE
Illinois Other 370984175 DPR LICENSE

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