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General NPI Number Information
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NPI Number | 1598273021
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Entity Type | Organization
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Legal Business Name | DIANNA CIANFROCCO, LCSW, PLLC
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Dates
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Enumeration Date | 01/18/2018
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Last Update Date | 01/18/2018
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Provider Practice Location Address
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Address Line | 8469 SENECA TPKE
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City | NEW HARTFORD
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State | NY
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Zip | 13413-4900
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Country | US
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Telephone | 315-271-6122
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Fax |
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Provider Business Mailing Address
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Address Line | 410 HICKORY ST
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City | ROME
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State | NY
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Zip | 13440-2110
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Country | US
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Telephone | 315-271-6122
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Fax |
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Authorized Official
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Title or Position | OWNER/LICENSED CLINICAL SOCIAL WORK
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Name | MS. DIANNA CIANFROCCO
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Credential | LCSW-R
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Telephone | 315-271-6122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R043165-1
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License Number State | NY
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