Lisa Kim Diamond
Individual provider Active NPI Counselor · North Grosvenordale, CT
NPI 1306646856 · NPPES record last updated Mar 14, 2025
Key facts
- NPI
- 1306646856
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- LSWA414220 (MA)
- Practice address
- 45 Bull Hill Rd
North Grosvenordale, CT 06255-2004 - Phone
- (860) 212-1936
- NPI assigned
- Mar 14, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LSWA414220 | MA | MD | Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | LSWA414220 | MA | Yes |
Addresses
Primary practice location
45 Bull Hill Rd
North Grosvenordale, CT 06255-2004
Mailing address
45 Bull Hill Rd
North Grosvenordale, CT 06255-2004
Phone (860) 212-1936
Other providers in North Grosvenordale, CT
- Behavior Services of New England
- Kailey Bennett
- Nita Chatterjee
- Natalee Giselle Cifuentes
- Tanya Lee Clark
- Kristine Marie Dipasquale
- Beth Ann Flannery Spillane
- Melissa Ann Gobin-Borski
- Christina M Labby
- Jennifer Ann Martell
All providers in North Grosvenordale, CT · Counselor in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 14, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.