Dimeola, Kimberly Ann
Dimeola, Kimberly Ann is an individual health care provider with primary practice located at 352 State St , North Haven CT 06473-3108. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Dimeola, Kimberly Ann can be contacted via phone (203) 781-4695.Contact Information
Primary practice address
352 State St
North Haven CT 06473-3108
Phone: (203) 781-4695
Fax: (203) 781-4624
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 000536 | Connecticut |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 006047 | Connecticut |
Profile Details
| NPI number | 1437428240 |
|---|---|
| LBN Legal business name | Dimeola, Kimberly Ann |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 22nd, 2011 |
| Last updated | Jan 24th, 2022 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1437428240 | NPPES |
| Connecticut | MEDICAID | 004082286 | |
| Connecticut | MEDICAID | 500000315 | |
| Connecticut | MEDICAID | 008022626 | |
| Connecticut | MEDICAID | 008038047 |
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