Individual
MRS. DIANE L NIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW LCADC
Contact information
Practice address
70 SPARTA AVE, STE 104, SPARTA, NJ 07871-1760
(973) 728-3938
(973) 728-7913
Mailing address
7 INDUSTRIAL RD, PEQUANNOCK, NJ 07440-1901
(973) 686-2227
(973) 686-2240
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
37LC00109100
NJ
1041C0700X
Clinical Social Worker
Primary
44SC05242300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
468737000
MAGELLAN
—
Enumeration date
01/30/2007
Last updated
01/27/2021
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