Individual
KIMBERLY ANN DIMEOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
352 STATE ST, NORTH HAVEN, CT 06473-3108
(203) 781-4695
(203) 781-4624
Mailing address
1 LONG WHARF DR, STE 321, NEW HAVEN, CT 06511-5991
(203) 781-4600
(203) 781-4624
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
000536
CT
1041C0700X
Clinical Social Worker
Primary
006047
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004082286
—
CT
05
—
008022626
—
CT
05
—
008038047
—
CT
05
—
500000315
—
CT
Enumeration date
12/22/2011
Last updated
01/24/2022
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