Provider Demographics
NPI:1598273021
Name:DIANNA CIANFROCCO, LCSW, PLLC
Entity Type:Organization
Organization Name:DIANNA CIANFROCCO, LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED CLINICAL SOCIAL WORK
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CIANFROCCO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:315-271-6122
Mailing Address - Street 1:410 HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13440-2110
Mailing Address - Country:US
Mailing Address - Phone:315-271-6122
Mailing Address - Fax:
Practice Address - Street 1:8469 SENECA TPKE
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-4900
Practice Address - Country:US
Practice Address - Phone:315-271-6122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-18
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR043165-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty