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NPI Code Detail

MEDICARE: DIANE CARNOALI LMSW

MEDICARE: DIANE CARNOALI LMSW
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
1104100000XSocial Worker6060KS
21041C0700XClinical Social Worker09923779CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
109923779OTHERCODORA COLORADO
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295702975
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANE CARNOALI LMSW
Provider Business Mailing Address
First Line : 1906 BLAKE AVE
Second Line :
City : GLENWOOD SPRINGS
State : CO
Zip : 81601-4259
Country : US
Telephone Number : 970-945-6535
Fax Number : 970-384-6782
Provider Business Practice Location Address
First Line : 1906 BLAKE AVE
Second Line :
City : GLENWOOD SPRINGS
State : CO
Zip : 81601-4227
Country : US
Telephone Number : 970-945-6535
Fax Number : 970-384-6782
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2006
Last Update Date : 03/26/2019

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