Active NPI
Nick Dietrick, LPC
- Professional Counselor
- McKinney, TX
National Provider Identifier
1356858856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 3900 S Stonebridge Dr Ste 604
McKinney, TX 75070-8051 - Phone
- (469) 734-8129
- NPI assigned
- Jan 5, 2018
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | Primary |
Addresses
Primary practice location
3900 S Stonebridge Dr Ste 604
McKinney, TX 75070-8051
Mailing address
3900 S Stonebridge Dr Ste 604
McKinney, TX 75070-8051
Phone (972) 839-0424
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 8, 2024 through Jan 8, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 75190 | TX | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515110400000",
"number": "1356858856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3900 S STONEBRIDGE DR STE 604",
"city": "MCKINNEY",
"state": "TX",
"postal_code": "750708051",
"telephone_number": "972-839-0424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3900 S STONEBRIDGE DR STE 604",
"city": "MCKINNEY",
"state": "TX",
"postal_code": "750708051",
"telephone_number": "469-734-8129"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIETRICK",
"first_name": "NICK",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-01-05",
"last_updated": "2018-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McKinney, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2018; 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.