Individual
KENDRA DIMINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW01430
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29289-6
BLUE SHIELD PROVIDER #
RI
01
—
412739
BLUE CHIP PROVIDER #
RI
Enumeration date
06/12/2006
Last updated
10/14/2025
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