Active NPI
Dianne Elizabeth Brower, LPC
- Professional Counselor
- Pawcatuck, CT
National Provider Identifier
1760130967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 03-918691
- 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
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 |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250611001100 | CT | Practitioner - Mental Health Counselor | 1850801598 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03-918691 | CT | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mystic Bridge to Wellness, LLC | Current | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.