Nancy Dolin Dietrich, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301012590 Issued in MI

Practice address

999 Haynes St Ste 300
Birmingham, MI 48009-6775

Phone

(248) 723-7111

NPI assigned

Jun 28, 2007

Sex

Female

Sole proprietor

Yes

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Birmingham Maple Clinic

  • Counselor
  • Troy, MI
  • NPI 1558412551
  NPD (past)
• Jeffrey a. London MD PC

  • Medical Specialty Clinic/Center
  • Troy, MI
  • NPI 1861708257
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 3, 2022 through Mar 3, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Nancy Dolin Dietrich Professional name

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1386841807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 PILGRIM AVE",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480091210",
            "telephone_number": "248-885-1044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 HAYNES ST STE 300",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480096775",
            "telephone_number": "248-723-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETRICH",
        "first_name": "NANCY",
        "middle_name": "DOLIN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-28",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801013713",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301012590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NANCY",
            "last_name": "DIETRICH",
            "middle_name": "DOLIN",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jann Marie Devereux, PH.D.
• Diane M. Cartwright LMSW PLLC
• Diatic Medical Supply, LLC
• Joanna Dicicco, R.D., C.D.E
• David Robert Dietrich, PH.D.
• Jeffrey S Dillingham, D.D.S.
• Jennifer Dillon, PT
• Dipilla Biomimetic Dentistry PLLC
• Robert Phillip Dipilla, DDS FAGD
• Jacob Diskin, MD

• All providers in Birmingham, MI
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; 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.

Verify at the official NPI Registry.