Mark Allen Dietrich, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

708 NE 6TH Street
Same
Crystal River, FL 34428-3704

Phone

(352) 212-8350

NPI assigned

Jul 13, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Mark Allen Dietrich Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1386166189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 NE 6TH STREET",
            "address_2": "SAME",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344283704",
            "telephone_number": "352-212-8350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 NE 6TH STREET",
            "address_2": "SAME",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344283704",
            "telephone_number": "352-212-8350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETRICH",
        "first_name": "MARK",
        "middle_name": "ALLEN",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-13",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARK",
            "last_name": "DIETRICH",
            "middle_name": "ALLEN",
            "prefix": "MR.",
            "credential": "MA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Alex Jonathan Dickert, M.D.
• Amanda Carroll Dickert, ARNP
• Jim C Dickert, DO
• Kaitlyn Dickert, PA-C
• Ryan Spencer Dickert, MD
• Virginia Dohn
• Maxfelonilo A Domingo, MD
• Donald H Pritchard MD PA
• Joy A. Dowe, ARNP
• Dr Alexis Bergan-Guzman DC PA

• Mental Health Counselor in Crystal River, FL
• Providers in Crystal River, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.