Active NPI
Trisha Dibiase, PMHNP-BC
- Psychiatric/Mental Health Nurse Practitioner
- Canton, CT
National Provider Identifier
1154895704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 8046
- Practice address
- 320 Albany Tpke
Canton, CT 06019-2540 - Phone
- (860) 385-3751
- Fax
- (860) 371-3105
- NPI assigned
- Jan 16, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 8046 | CT | Primary |
Addresses
Primary practice location
320 Albany Tpke
Canton, CT 06019-2540
Mailing address
320 Albany Tpke
Canton, CT 06019-2540
Phone (860) 385-3751
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 |
|---|---|---|---|
| 8046 | CT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MC1 Healthcare | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Substance Abuse Rehabilitation Facility
- Canaan, CT
- NPI 1083883177
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696377600000",
"number": "1154895704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 ALBANY TPKE",
"city": "CANTON",
"state": "CT",
"postal_code": "060192540",
"telephone_number": "860-385-3751",
"fax_number": "860-371-3105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 ALBANY TPKE",
"city": "CANTON",
"state": "CT",
"postal_code": "060192540",
"telephone_number": "860-385-3751",
"fax_number": "860-371-3105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIBIASE",
"first_name": "TRISHA",
"credential": "PMHNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-16",
"last_updated": "2023-10-04",
"certification_date": "2023-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "CT",
"license": "8046",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.