Provider Demographics
NPI:1659719029
Name:RIZZO-KORMONDY, DINA MICHELE (LPC)
Entity Type:Individual
Prefix:MS
First Name:DINA
Middle Name:MICHELE
Last Name:RIZZO-KORMONDY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:DINA
Other - Middle Name:M
Other - Last Name:KORMONDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:23 WINTHROP RD
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-4018
Mailing Address - Country:US
Mailing Address - Phone:732-289-8822
Mailing Address - Fax:
Practice Address - Street 1:358 WALL ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-1517
Practice Address - Country:US
Practice Address - Phone:609-921-1555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-07
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00147000101Y00000X
NJ37PC00599900101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor