Provider Demographics
NPI:1083343784
Name:CARINA ANTONINO DIMARE, MS, PLC
Entity Type:Organization
Organization Name:CARINA ANTONINO DIMARE, MS, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTONINO DIMARE
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:413-374-3921
Mailing Address - Street 1:1009 FALLS RD
Mailing Address - Street 2:
Mailing Address - City:SHELBURNE
Mailing Address - State:VT
Mailing Address - Zip Code:05482-7035
Mailing Address - Country:US
Mailing Address - Phone:413-374-3921
Mailing Address - Fax:
Practice Address - Street 1:1009 FALLS RD
Practice Address - Street 2:
Practice Address - City:SHELBURNE
Practice Address - State:VT
Practice Address - Zip Code:05482-7035
Practice Address - Country:US
Practice Address - Phone:413-374-3921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty