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NPI Code Detail

MEDICARE: DR. NINA DITOMMASO PHD, LPC

MEDICARE: DR. NINA DITOMMASO PHD, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorLPC0000002324TN
2101YP2500XProfessional CounselorLPC0000002324TN

General Provider Information

NPI Number : 1093085318
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NINA DITOMMASO PHD, LPC
Provider Business Mailing Address
First Line : 4800 N SCOTTSDALE RD STE 2500
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85251-7630
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10434 JACKSON OAKS WAY
Second Line :
City : KNOXVILLE
State : TN
Zip : 37922-3293
Country : US
Telephone Number : 865-281-1361
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2012
Last Update Date : 02/26/2026

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