Provider Demographics
NPI:1447476106
Name:SENA, DIANNE (MSW)
Entity type:Individual
Prefix:
First Name:DIANNE
Middle Name:
Last Name:SENA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 MEETING HOUSE LN
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11968-5051
Mailing Address - Country:US
Mailing Address - Phone:631-287-3094
Mailing Address - Fax:631-287-3794
Practice Address - Street 1:351 MEETING HOUSE LN
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11968-5051
Practice Address - Country:US
Practice Address - Phone:631-287-3094
Practice Address - Fax:631-287-3794
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR045606101YM0800X
OHI4426101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN5M761Medicare ID - Type Unspecified