Diane M.McKissick, L.C.S.W.-C., LTD

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

07889 Issued in MD

Legal business name

DIANE M.MCKISSICK, L.C.S.W.-C., LTD

Practice address

41201 Friendship CT
Mechanicsville, MD 20659-3877

Phone

(301) 373-7750

Fax

(301) 373-2626

NPI assigned

Feb 26, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Diane M McKissick, LSCW-C

Title

Owner

Phone

(301) 373-7750

Specialties & licenses 1

Addresses

Other names 1

• LoneSpirit Counseling Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780710657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41201 FRIENDSHIP CT",
            "city": "MECHANICSVILLE",
            "state": "MD",
            "postal_code": "206593877",
            "telephone_number": "301-373-7750",
            "fax_number": "301-373-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41201 FRIENDSHIP CT",
            "city": "MECHANICSVILLE",
            "state": "MD",
            "postal_code": "206593877",
            "telephone_number": "301-373-7750",
            "fax_number": "301-373-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIANE M.MCKISSICK, L.C.S.W.-C., LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCKISSICK",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-373-7750",
        "authorized_official_credential": "LSCW-C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "07889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LoneSpirit Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cheyanne Marie Cornwell, DMD
• Tori Marie Lewis Dauphinais, CRNP
• Lisa Dean, BCBA
• Kara Marie McCray Demer, DDS
• Dewbow Counseling
• Elinor Phillips Dickshinski, M.S., NCC, L.C.P.C
• Melanie Lynn Donis, DVM
• Vickie Elsesser-Vu, LCSWC
• Joan J Emberland, DDS
• Melissa Lynn Fallabel, OTR/L

• Clinical Social Worker in Mechanicsville, MD
• Providers in Mechanicsville, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.