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General NPI Number Information
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NPI Number | 1699209098
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Entity Type | Organization
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Legal Business Name | STEVEN DIMARZO, LMHC, PLLC
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Dates
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Enumeration Date | 04/12/2017
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Last Update Date | 04/12/2017
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Provider Practice Location Address
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Address Line | 103 PLEASANTVIEW DR
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City | LIVERPOOL
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State | NY
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Zip | 13088-6443
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Country | US
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Telephone | 315-218-7640
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Fax |
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Provider Business Mailing Address
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Address Line | 1900 BREWERTON RD PO BOX 54
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City | SYRACUSE
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State | NY
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Zip | 13211-1763
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEVEN DIMARZO
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Credential | LMHC
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Telephone | 315-218-7640
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 007883
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License Number State | NY
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