Healthcare Provider Details

I. General information

NPI: 1356631865
Provider Name (Legal Business Name): DIANNA MARIE DINARDO MS, LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2011
Last Update Date: 12/21/2022
Certification Date: 12/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

87 S MAIN ST STE 13
NEWTOWN CT
06470-2315
US

IV. Provider business mailing address

87 S MAIN ST STE 13
NEWTOWN CT
06470-2315
US

V. Phone/Fax

Practice location:
  • Phone: 203-470-7097
  • Fax: 203-049-7743
Mailing address:
  • Phone: 203-707-0974
  • Fax: 203-304-9774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number002030
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number002030
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: