Healthcare Provider Details

I. General information

NPI: 1508563313
Provider Name (Legal Business Name): DINA ALEXIS SKEMPRIS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2023
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 MUNSON RD
FARMINGTON CT
06032-2012
US

IV. Provider business mailing address

263 FARMINGTON AVE
FARMINGTON CT
06030-8082
US

V. Phone/Fax

Practice location:
  • Phone: 860-679-6551
  • Fax: 860-679-0131
Mailing address:
  • Phone: 860-679-6551
  • Fax: 860-679-0131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number14251
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: