Diana Ro, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301015909 Issued in MI

Practice address

4020 Copper VW Ste 104F
Traverse City, MI 49684-7041

Phone

(231) 947-2255

NPI assigned

Sep 26, 2013

Last updated

Jul 11, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Previously, effective Oct 1, 2022 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Resilient Mental Health

  • Clinical Psychologist
  • Traverse City, MI
  • NPI 1982358719
  NPD Authorized official

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

{
    "created_epoch": "1380153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1144657800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 COPPER VW STE 104F",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847041",
            "telephone_number": "231-947-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 COPPER VW STE 104F",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847041",
            "telephone_number": "231-947-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RO",
        "first_name": "DIANA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-26",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301015909",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie P Ritter, O.D.
• River of Life Chiropractic and Wellness PLLC
• RJMW, LLC (C.a.R.E.)
• RLK Investments, Inc (Comfort Keepers 615)
• RLK Investments, Inc. (Comfort Keepers)
• Diane Roach, R.D.
• Sarah Robarge
• Cristine Robb, LMSW
• Cherry Robbins
• Christina Marie Robbins, OTR/L

• Clinical Psychologist in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.