Healthcare Provider Details

I. General information

NPI: 1942178397
Provider Name (Legal Business Name): DIOSA MENTAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2025
Last Update Date: 03/07/2026
Certification Date: 03/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 E MAIN ST STE 200
NEW ALBANY IN
47150-5842
US

IV. Provider business mailing address

1015 E MAIN ST STE 200
NEW ALBANY IN
47150-5842
US

V. Phone/Fax

Practice location:
  • Phone: 812-605-5201
  • Fax: 812-605-5201
Mailing address:
  • Phone: 812-605-5201
  • Fax: 812-605-5201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ANNA DOMIRAY
Title or Position: OWNER
Credential: LCSW
Phone: 812-605-5201