Anderson, Diana

Anderson, Diana is an individual health care provider with primary practice located at 495 Congress Ave , New Haven CT 06519. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Anderson, Diana can be contacted via phone (032) 285-2678.

Contact Information

Primary practice address
495 Congress Ave New Haven CT 06519
Phone: (032) 285-2678
Fax: (203) 781-4654
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 3457 Connecticut
Behavioral Health & Social Service Providers / Professional 101YP2500X 3457 Connecticut

Profile Details

NPI number 1124380514
LBN Legal business name Anderson, Diana
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2012
Last updated Jul 27th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124380514 NPPES
Connecticut MEDICAID 004082260
Connecticut MEDICAID 008022622
Connecticut MEDICAID 008001325
Connecticut MEDICAID 008080804

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