Hearst Ikeda, Diana
Hearst Ikeda, Diana is an sole proprietor health care provider with primary practice located at 20 Tremont St Suite 12 A, Duxbury MA 02332-5310. She recently has 9 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Adult Development & Aging, Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Counseling, Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Family. Behavioral Health & Social Service Providers / Cognitive & Behavioral is her primary health care specialty. Hearst Ikeda, Diana can be contacted via phone (781) 934-6390.Contact Information
Primary practice address
20 Tremont St Suite 12 A
Duxbury MA 02332-5310
Phone: (781) 934-6390
Fax: (781) 934-9991
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 6917 | Massachusetts |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 6917 | Massachusetts |
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 6917 | Massachusetts |
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 103TA0400X | 6917 | Massachusetts |
| Behavioral Health & Social Service Providers / Adult Development & Aging | 103TA0700X | 6917 | Massachusetts |
| Behavioral Health & Social Service Providers / Cognitive & Behavioral | 103TB0200X | 6917 | Massachusetts |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 6917 | Massachusetts |
| Behavioral Health & Social Service Providers / Counseling | 103TC1900X | 6917 | Massachusetts |
| Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X | 6917 | Massachusetts |
| Behavioral Health & Social Service Providers / Family | 103TF0000X | 6917 | Massachusetts |
Profile Details
| NPI number | 1124146717 |
|---|---|
| LBN Legal business name | Hearst Ikeda, Diana |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 26th, 2007 |
| Last updated | Dec 13th, 2013 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124146717 | NPPES |
| Massachusetts | MEDICAID | W05211 | |
| Massachusetts | Other | W05611 | |
| Massachusetts | Other | 407109 |
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