Individual provider Active NPI

Dianna Lynn Pratt, PSYD

  • Clinical Psychologist
  • Marysville, MI
National Provider Identifier
1639209422
Registry record updated Oct 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301014401 Issued in MI
Practice address
1600 Gratiot Blvd Ste 4
Marysville, MI 48040-1145
Phone
(810) 364-5800
Fax
(810) 364-1200
NPI assigned
Mar 7, 2007
Last updated
Oct 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301014401 MI Primary
Clinical Child & Adolescent Psychologist 103TC2200X 6301014401 MI
Family Psychologist 103TF0000X 6301014401 MI

Addresses

Primary practice location

1600 Gratiot Blvd Ste 4
Marysville, MI 48040-1145

Mailing address

1600 Gratiot Blvd Ste 4
Marysville, MI 48040-1145
Phone (810) 364-5800

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20060224000062 MI Practitioner - Clinical Psychologist 9032125380 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emca Counseling PCGroup PAC ID 2062511934, 3 clinicians

Practice addresses (Care Compare)

1600 Gratiot Blvd
BLDG B
Marysville, MI 48040-1145
Phone (810) 364-5800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6301014401MIMDFamily Psychologist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791072000000",
    "number": "1639209422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 GRATIOT BLVD STE 4",
            "city": "MARYSVILLE",
            "state": "MI",
            "postal_code": "480401145",
            "telephone_number": "810-364-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 GRATIOT BLVD STE 4",
            "city": "MARYSVILLE",
            "state": "MI",
            "postal_code": "480401145",
            "telephone_number": "810-364-5800",
            "fax_number": "810-364-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATT",
        "first_name": "DIANNA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2026-10-04",
        "certification_date": "2026-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301014401",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MI",
            "license": "6301014401",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "MI",
            "license": "6301014401",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, MI

Sources for this page

Verify at the official NPI Registry.