Healthcare Provider Details

I. General information

NPI: 1124659149
Provider Name (Legal Business Name): CARIANNE DISPIGNO LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2020
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

987 R C HOAG DR
SALAMANCA NY
14779-1365
US

IV. Provider business mailing address

987 R C HOAG DR
SALAMANCA NY
14779-1365
US

V. Phone/Fax

Practice location:
  • Phone: 716-945-5894
  • Fax: 716-242-6345
Mailing address:
  • Phone: 716-945-5894
  • Fax: 716-242-6345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number013885
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: