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DR. DIANE CASANUEVA ELLIOTT PHD NPI 1083768402


NPI Information

NPI: 1083768402
Provider Name: DR. DIANE CASANUEVA ELLIOTT, PHD
Classification: Psychologist - 103TC2200X
Entity Type: Individual

Specialization: Clinical Child & Adolescent

Address:
277 PIERCE AVE
MACON, GA
ZIP 31204
Phone: (478) 755-0060
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DR. Diane Casanueva Elliott, PHD is a clinical child and adolescent psychologist in Macon, GA. The provider is a psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents. DR. Diane Casanueva Elliott, PHD NPI is 1083768402. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

277 PIERCE AVE
MACON, GA
ZIP 31204-419
Phone: (478) 755-0060
Fax: (478) 743-3508

The enumeration date for this NPI number is 1/23/2007 and was last updated on 6/13/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TC2200XPsychologistClinical Child & AdolescentPST000800GEORGIANo
2103TC2200XPsychologistClinical Child & AdolescentPSY003112GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
168BBGTQMEDICARE PINGEORGIA
2556624291AMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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