Individual
DIANE J RICHARDS-PENLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
60 &70 COTTAGE ST., DANIELSON, CT 06329
(860) 774-0215
(860) 774-2256
Mailing address
907 KETTLETOWN RD, SOUTHBURY, CT 06488-2641
(203) 560-6301
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
001484
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008023170
—
CT
05
—
008024427
—
CT
05
—
008039745
—
CT
05
—
008042339
—
CT
05
—
008109605
—
CT
Enumeration date
07/21/2023
Last updated
10/02/2023
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