Active NPI
Dianne M Goetsch
- Clinical Psychologist
- Dearborn, MI
National Provider Identifier
1548690704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6361003450
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301015777 | MI | MD | Clinical Psychologist |
| 6361003450 | MI | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DMG Psychology | Psychologist | Current | Accepting new patients |
| The Symmetry Group, LLC | Clinical | Past | 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.
-
- Clinical Psychologist
- Dearborn, MI
- NPI 1750087425
-
- Clinical Psychologist
- Dearborn, MI
- NPI 1568860898
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.