Provider Demographics
NPI:1366971855
Name:VINCOLI-DIROMA, MICHELLE P (MS, LPC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:P
Last Name:VINCOLI-DIROMA
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 NEWTOWN AVE APT 12
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-2329
Mailing Address - Country:US
Mailing Address - Phone:914-525-2400
Mailing Address - Fax:
Practice Address - Street 1:38B GROVE ST
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4665
Practice Address - Country:US
Practice Address - Phone:914-525-2400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-08
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003097101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional