National Provider Identifier

Diane S Jerdan, LCSW

Diane S Jerdan, LCSW is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Ithaca, NY and a listed phone number of (607) 275-3675.

NPI 1386721371Ithaca, NYClinical Social Worker

Profile Overview

NPI
1386721371
Provider Type
Individual
Primary Specialty
Clinical Social Worker
Enumeration Date
November 01, 2006
Last Updated
July 08, 2007

Practice Location

  • 122 West Court St
  • Ithaca, NY 14850

Phone: (607) 275-3675

Specialties

  • Clinical Social Worker (1041C0700X)
Full Record
NPI
1386721371
Entity Type
Individual
Last Name
Jerdan
First Name
Diane
Middle Name
S
Name Prefix
MS.
Credential
LCSW
Mailing Street Address
122 West Court St
Mailing City
Ithaca
Mailing State
NY
Mailing ZIP Code
14850
Mailing Country
US
Mailing Phone
(607) 275-3675
Practice Street Address
122 West Court St
Practice City
Ithaca
Practice State
NY
Practice ZIP Code
14850
Practice Country
US
Practice Phone
(607) 275-3675
Enumeration Date
November 01, 2006
Last Updated
July 08, 2007
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Clinical Social Worker (1041C0700X)