Individual provider Active NPI

Dianne M Goetsch

  • Clinical Psychologist
  • Dearborn, MI
National Provider Identifier
1548690704
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6361003450 Issued in MI
Practice address
3070 Lindenwood Dr
Dearborn, MI 48120-1312
Phone
(313) 528-9146
NPI assigned
Nov 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6361003450 MI
Clinical Psychologist 103TC0700X 6301015777 MI
Clinical Psychologist 103TC0700X 6361003450 MI Primary

Addresses

Primary practice location

3070 Lindenwood Dr
Dearborn, MI 48120-1312

Mailing address

18518 Outer Dr
Dearborn, MI 48128-1874
Phone (313) 528-9146

Other practice location 1

18518 Outer Dr
Dearborn, MI 48128-1874
Phone (313) 528-9146

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190626002393 MI Practitioner - Psychologist Billing Independently 1456579127 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6301015777MIMDClinical Psychologist
6361003450MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
DMG Psychology Psychologist CurrentSince Jul 1, 2023 Accepting new patients
The Symmetry Group, LLC Clinical PastSince Jul 16, 2014 Accepting new patients

Locations

23400 Park St
Dearborn, MI 48124
Phone (313) 241-6154

18518 Outer Dr
Dearborn, MI 48128
Phone (313) 288-2450

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1385337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1548690704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18518 OUTER DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481281874",
            "telephone_number": "313-528-9146",
            "fax_number": "313-558-8384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3070 LINDENWOOD DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481201312",
            "telephone_number": "313-528-9146"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18518 Outer Dr",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481281874",
            "country_code": "US",
            "telephone_number": "313-528-9146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOETSCH",
        "first_name": "DIANNE",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-25",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6361003450",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301015777",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6361003450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.