Diane L Wetzig, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

4446 Issued in OH

Practice address

3690 Orange PL
Ste 430
Beachwood, OH 44122-4464

Phone

(216) 464-5330

NPI assigned

Mar 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

North Coast Mental Health Associates IncGroup PAC ID 5597661439, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• North Coast Mental Health Associates Inc.

  • Prescribing (Medical) Psychologist
  • Beachwood, OH
  • NPI 1033219225
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386633600000",
    "number": "1467413187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3690 ORANGE PL",
            "address_2": "STE 430",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441224464",
            "telephone_number": "216-464-5330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3690 ORANGE PL",
            "address_2": "STE 430",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441224464",
            "telephone_number": "216-464-5330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETZIG",
        "first_name": "DIANE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2013-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "4446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0903802",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE",
            "identifier": "34174188300",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Western Reserve Dermatology, Inc
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• Western Reserve Vision Care, Inc.
• Khannah Keziah Wetmore, LISW-S
• Dymon Whatley, QMHS
• Jessica Diondra Liane Wheeler
• Benjamin A White, PT, DPT
• Chantaisia White
• Laurie Frados White

• Psychologist in Beachwood, OH
• Providers in Beachwood, OH by specialty
• Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.