Individual provider Active NPI

Craig Andrew Dike, PSY.D.

  • Clinical Psychologist
  • Duluth, GA
National Provider Identifier
1023247012
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
38905 Issued in TX
Practice address
3700 Crestwood Pkwy NW Ste 500
Duluth, GA 30096-5585
Phone
(678) 924-5756
NPI assigned
Jul 10, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 001175 IA
Clinical Psychologist 103TC0700X 38905 TX Primary

Addresses

Primary practice location

3700 Crestwood Pkwy NW Ste 500
Duluth, GA 30096-5585

Mailing address

7400 Merton Minter St
116B Psychology Service
San Antonio, TX 78229-4404
Phone (210) 617-5121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2376KSMDMarriage & Family Therapist
001175IAMDPhysical Therapy Assistant
2053ALMDPhysician Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1247184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1023247012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 MERTON MINTER ST",
            "address_2": "116B PSYCHOLOGY SERVICE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294404",
            "telephone_number": "210-617-5121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 CRESTWOOD PKWY NW STE 500",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965585",
            "telephone_number": "678-924-5756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIKE",
        "first_name": "CRAIG",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-10",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IA",
            "license": "001175",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "38905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

Verify at the official NPI Registry.