Kimberly Ann Dimeola

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

006047 Issued in CT

Practice address

352 State St
North Haven, CT 06473-3108

Phone

(203) 781-4695

Fax

(203) 781-4624

NPI assigned

Dec 22, 2011

Last updated

Jan 24, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Back to Health of Branford, LLC

  • Internal Medicine Physician
  • Branford, CT
  • NPI 1215958772
  NPD (past)

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

{
    "created_epoch": "1324512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642982400000",
    "number": "1437428240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LONG WHARF DR",
            "address_2": "STE 321",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115991",
            "telephone_number": "203-781-4600",
            "fax_number": "203-781-4624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "352 STATE ST",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064733108",
            "telephone_number": "203-781-4695",
            "fax_number": "203-781-4624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMEOLA",
        "first_name": "KIMBERLY ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-22",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "000536",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004082286",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500000315",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008022626",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008038047",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hailey Dias, LADC
• Vincent Dicola, MD, FACC, NASPE
• Philip Andrew Diglio, LO
• Shaniqua Dillard, LPCA
• Jennifer Dilungo, PA-C
• Discovery Health & Wellness Center, LLC
• Divine Smiles North Haven PC
• Ruel Dixon, BCBA
• Ashlee Doherty, DNP, FNP
• Danielle Dombroski

• Clinical Social Worker in North Haven, CT
• Providers in North Haven, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.