Michael J Didier, MS, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

35000820A Issued in IN

Practice address

2805 Fairfield Ave
Fort Wayne, IN 46807-1218

Phone

(260) 456-4880

Fax

(260) 486-3559

NPI assigned

Jul 17, 2006

Last updated

Feb 28, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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

• Pancner Psychiatric Associates, PC

  • Psychologist
  • Fort Wayne, IN
  • NPI 1801019096
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362009600000",
    "number": "1487671996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2805 FAIRFIELD AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468071218",
            "telephone_number": "260-456-4880",
            "fax_number": "260-456-3559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 FAIRFIELD AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468071218",
            "telephone_number": "260-456-4880",
            "fax_number": "260-486-3559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIDIER",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "MS, LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2013-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "35000820A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Rose Dickman, PHARMD
• Alisha Michelle Dickmeyer, PA-C
• Mark C. Dickmeyer, MD
• Briana Dickson
• Lauren Marie Didier, PA-C
• Susan E Didion, RN
• Ryan Diederich
• Martin Joseph Diedrich, COTA
• Jill M Diedring, NP
• David M Diehl, DDS

• Marriage & Family Therapist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Marriage & Family Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2013; 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.