MEDICARE: STEPHANIE DIARBI LMHC

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
1	101YM0800X	Mental Health Counselor	010974	NY

General Provider Information

NPI Number	:	1710570452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE DIARBI LMHC

Provider Business Mailing Address
First Line	:	618 76TH ST FL 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-3326
Country	:	US
Telephone Number	:	347-756-9565
Fax Number	:

Provider Business Practice Location Address
First Line	:	618 76TH ST FL 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-3326
Country	:	US
Telephone Number	:	347-756-9565
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2021
Last Update Date	:	02/13/2021

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