MEDICARE: MRS. ILARIA DIBERNARDO-PHILLIPS CT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	C.2608000	OH

General Provider Information

NPI Number	:	1316420516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ILARIA DIBERNARDO-PHILLIPS CT

Provider Business Mailing Address
First Line	:	1346 TENAGRA WAY
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43228-9192
Country	:	US
Telephone Number	:	330-671-3258
Fax Number	:

Provider Business Practice Location Address
First Line	:	4664 LARWELL DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-3621
Country	:	US
Telephone Number	:	614-487-7805
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2018
Last Update Date	:	05/07/2026

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