Active NPI
Michelle R Dyer
- Addiction (Substance Use Disorder) Counselor
- San Bernardino, CA
National Provider Identifier
1356579866
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 2130 North Arrowhead Avenue
Ste. 109
San Bernardino, CA 92405 - Phone
- (909) 881-0390
- Fax
- (909) 881-0391
- NPI assigned
- Jun 24, 2009
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CA | Primary |
Addresses
Primary practice location
2130 North Arrowhead Avenue
Ste. 109
San Bernardino, CA 92405
Mailing address
3430 Cosgwell Road
Covina, CA 91732
Phone (626) 536-0790
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245801600000",
"number": "1356579866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3430 COSGWELL ROAD",
"city": "COVINA",
"state": "CA",
"postal_code": "91732",
"telephone_number": "626-536-0790"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2130 NORTH ARROWHEAD AVENUE",
"address_2": "STE. 109",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "92405",
"telephone_number": "909-881-0390",
"fax_number": "909-881-0391"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DYER",
"first_name": "MICHELLE",
"middle_name": "R",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-24",
"last_updated": "2009-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.