Active NPI
Diane C Desmarais, LPC, LADC
- Professional Counselor
- Waterbury, CT
National Provider Identifier
1053628438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 001894
- Practice address
- 141 E Main St
Waterbury, CT 06702-2310 - Phone
- (203) 575-0466
- Fax
- (203) 575-1817
- NPI assigned
- Sep 8, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 000822 | CT | |
| Professional Counselor | 101YP2500X | 001894 | CT | Primary |
Addresses
Primary practice location
141 E Main St
Waterbury, CT 06702-2310
Mailing address
141 E Main St
Waterbury, CT 06702-2310
Phone (203) 575-0466
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001894 | CT | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329868800000",
"number": "1053628438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "141 E MAIN ST",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067022310",
"telephone_number": "203-575-0466",
"fax_number": "203-575-1817"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "141 E MAIN ST",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067022310",
"telephone_number": "203-575-0466",
"fax_number": "203-575-1817"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESMARAIS",
"first_name": "DIANE",
"middle_name": "C",
"credential": "LPC, LADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-08",
"last_updated": "2012-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CT",
"license": "000822",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CT",
"license": "001894",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waterbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.