Jamie-Ann Dieterle, LLMSW
Individual provider Active NPI Clinical Social Worker · Negaunee, MI
NPI 1013450899 · NPPES record last updated Nov 28, 2016
Key facts
- NPI
- 1013450899
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 6801099572 (MI)
- Practice address
- 104 Malton Rd
Negaunee, MI 49866-2000 - Phone
- (906) 228-4692
- Fax
- (906) 228-2830
- NPI assigned
- Nov 28, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801099572 | MI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Great Lakes Recovery Centers | Past | Accepting new patients | |
| Great Lakes Recovery Centers | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/CEJEBD/Endpoint/CEJEBD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801099572 | MI | Yes |
Addresses
Primary practice location
104 Malton Rd
Negaunee, MI 49866-2000
Mailing address
104 Malton Rd
Negaunee, MI 49866-2000
Phone (906) 228-4692
Other providers in Negaunee, MI
- County of Marquette
- Christina Crow-Roberts
- Joel Ryan Dank
- Lindsay Ann Demers
- Derrick Anthony Depetro
- Corey Matthew Doan
- Nicole Anne Dorie
- Abby Duvall
- Eastwood Nursing Center of Negaunee, Inc.
- Shana Jane Epps
All providers in Negaunee, MI · Clinical Social Worker in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 28, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.