Individual provider Active NPI

Dianna Bruno, PSYD, LMHC

  • Clinical Psychologist
  • Niagara Falls, NY
National Provider Identifier
1073554556
Registry record updated Mar 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
017707-1 Issued in NY
Practice address
419 Walnut Ave
Niagara Falls, NY 14301-1725
Phone
(716) 285-1904
Fax
(716) 284-8262
NPI assigned
Jun 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 017707-1 NY Primary

Addresses

Primary practice location

419 Walnut Ave
Niagara Falls, NY 14301-1725

Mailing address

419 Walnut Ave
Niagara Falls, NY 14301-1725
Phone (716) 285-1904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070716000089 NY Practitioner - Clinical Psychologist 3678673993 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

144 Genesee St
Buffalo, NY 14203-1560

275 Northepoint Pkwy
Suite 50
Amherst, NY 14228-1895

3 Corporate Dr
Suite 100
Halfmoon, NY 12065-8635

3 E Evergreen Rd
Suite 123
New City, NY 10956-5145

397 Little Neck Rd
3300 South BLDG. 300
Virginia Beach, VA 23452-7327

419 Walnut Ave
Niagara Falls, NY 14301-1725

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
017707-1NYMDClinical Psychologist
017707NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Medical Concierge Services, PLLC CurrentSince Aug 6, 2021 Accepting new patients
Louis P. Labarber, PHD, CSW, P.C. CurrentSince Dec 1, 2006 Accepting new patients
Junaid Hashim MD PastSince Apr 26, 2020 Accepting new patients

Locations

1785 Route 9
Halfmoon, NY 12065
Phone (518) 238-6028

419 Walnut Ave
Niagara Falls, NY 14301
Phone (716) 285-1904

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1073554556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 WALNUT AVE",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143011725",
            "telephone_number": "716-285-1904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 WALNUT AVE",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143011725",
            "telephone_number": "716-285-1904",
            "fax_number": "716-284-8262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNO",
        "first_name": "DIANNA",
        "name_prefix": "Dr.",
        "credential": "PSYD, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "017707-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niagara Falls, NY

Sources for this page

Verify at the official NPI Registry.