NPI 1003062415

Diana Melisa Idelson, LCSW

Practitioner Clinical Social Worker Southport, NC

Practice location

Address: 4320 Southport Supply Rd SE STE 200, Southport, NC 28461-8056
Phone: (910) 457-0800
Fax: (910) 457-1072
Mailing address: 3950 Pepperberry Ln, Southport, NC 28461-8481

Registered specialties

Clinical Social Worker Primary

Behavioral Health & Social Service Providers Taxonomy 1041C0700X Licence C012223 (NC)

Other Social Worker providers in North Carolina →

Registry record

NPI: 1003062415
Entity type: Individual
Sex (as registered): Female
NPI issued: 18 Aug 2008
Record last updated: 7 Jan 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.