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General NPI Number Information
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NPI Number | 1144109877
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Entity Type | Individual
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Provider Name | DIANCA CHERYSE TYSON LPC-A
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Gender | Female
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Dates
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Enumeration Date | 08/27/2025
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 3190 WHITNEY AVE UNIT 6
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City | HAMDEN
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State | CT
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Zip | 06518-2340
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Country | US
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Telephone | 203-278-6989
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Fax | 203-651-1462
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Provider Business Mailing Address
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Address Line | 25 FRANKLIN RD APT B
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City | HAMDEN
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State | CT
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Zip | 06517-3638
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Country | US
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Telephone | 203-278-6989
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Fax | 203-286-2349
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 9349
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License Number State | CT
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