Active NPI
Molly Diana
- Art Therapist
- Clawson, MI
National Provider Identifier
1295207389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Art Therapist
- License
- 11-056
- Practice address
- 432 Charlevoix St
Clawson, MI 48017-2036 - Phone
- (248) 470-2063
- NPI assigned
- Dec 30, 2018
- Last updated
- Dec 30, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Art Therapist | 221700000X | 11-056 | MI | Primary |
Addresses
Primary practice location
432 Charlevoix St
Clawson, MI 48017-2036
Mailing address
432 Charlevoix St
Clawson, MI 48017-2036
Phone (248) 470-2063
Other practice location 1
432 Charlevoix St
Clawson, MI 48017-2036
Phone (248) 470-2063
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11-056 | MI | MD | Art Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1546128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546128000000",
"number": "1295207389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "432 CHARLEVOIX ST",
"city": "CLAWSON",
"state": "MI",
"postal_code": "480172036",
"telephone_number": "248-470-2063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "432 CHARLEVOIX ST",
"city": "CLAWSON",
"state": "MI",
"postal_code": "480172036",
"telephone_number": "248-470-2063"
}
],
"practiceLocations": [
{
"address_1": "432 Charlevoix St",
"address_purpose": "LOCATION",
"city": "Clawson",
"state": "MI",
"postal_code": "480172036",
"country_code": "US",
"telephone_number": "248-470-2063",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DIANA",
"first_name": "MOLLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-12-30",
"last_updated": "2018-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "221700000X",
"taxonomy_group": "",
"desc": "Art Therapist",
"state": "MI",
"license": "11-056",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clawson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.