Individual provider Active NPI

Dianne Elizabeth Brower, LPC

  • Professional Counselor
  • Pawcatuck, CT
National Provider Identifier
1760130967
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
03-918691 Issued in CT
Practice address
155 W Broad St Apt 1
Pawcatuck, CT 06379-1824
Phone
(860) 333-7800
NPI assigned
Mar 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 03-918691 CT Primary

Addresses

Primary practice location

155 W Broad St Apt 1
Pawcatuck, CT 06379-1824

Mailing address

155 W Broad St Apt 1
Pawcatuck, CT 06379-1824
Phone (860) 333-7800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20250611001100 CT Practitioner - Mental Health Counselor 1850801598 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
03-918691CTMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mystic Bridge to Wellness, LLC CurrentSince May 1, 2025 Accepting new patients

Locations

80 Stonington Rd
Ste A3
Mystic, CT 06355
Phone (860) 536-1699

47 Water St
Ste 101
Mystic, CT 06355
Phone (617) 416-0597

47 Water St
Ste 202
Mystic, CT 06355
Phone (617) 416-0597

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.

NPI Registry JSON

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

{
    "created_epoch": "1647388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1760130967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 W BROAD ST APT 1",
            "city": "PAWCATUCK",
            "state": "CT",
            "postal_code": "063791824",
            "telephone_number": "860-333-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 W BROAD ST APT 1",
            "city": "PAWCATUCK",
            "state": "CT",
            "postal_code": "063791824",
            "telephone_number": "860-333-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWER",
        "first_name": "DIANNE",
        "middle_name": "ELIZABETH",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-16",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "03-918691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawcatuck, CT

Sources for this page

Verify at the official NPI Registry.