=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154606184
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DIANNE HOWE LPC/LADC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/21/2011
-----------------------------------------------------
Last Update Date | 10/21/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 189 STORRS RD
-----------------------------------------------------
City | MANSFIELD CENTER
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06250-1683
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-456-1311
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 428 HARTFORD TPKE SUITE 105
-----------------------------------------------------
City | VERNON
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06066-4841
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-870-0119
-----------------------------------------------------
Fax | 860-870-0119
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 000331
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number | 000202
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------