Healthcare Provider Details

I. General information

NPI: 1982900486
Provider Name (Legal Business Name): ARIANA DEIGNAN-KOSMIDES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2011
Last Update Date: 05/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98 YORK ST
NEW HAVEN CT
06511-5602
US

IV. Provider business mailing address

98 YORK ST
NEW HAVEN CT
06511-5602
US

V. Phone/Fax

Practice location:
  • Phone: 475-434-0472
  • Fax: 203-785-6860
Mailing address:
  • Phone: 475-434-0472
  • Fax: 203-785-6860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: