Marilyn M Dyre PHD LCSW PC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MARILYN M DYRE PHD LCSW PC

Practice address

333 Commerce Dr
Ste 150
Crystal Lake, IL 60014

Phone

(815) 455-1884

Fax

(815) 455-1896

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Marilyn Marie Dyre, PHD

Title

Psychotherapist President

Phone

(815) 455-1884

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245338599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 COMMERCE DR",
            "address_2": "STE 150",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "60014",
            "telephone_number": "815-455-1884",
            "fax_number": "815-455-1896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 COMMERCE DR",
            "address_2": "STE 150",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "60014",
            "telephone_number": "815-455-1884",
            "fax_number": "815-455-1896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARILYN M DYRE PHD LCSW PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DYRE",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST PRESIDENT",
        "authorized_official_telephone_number": "815-455-1884",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Crystal Lake, IL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.