Individual provider Active NPI

Sigrid Julian Dixon, PHD

  • Clinical Psychologist
  • East Lansing, MI
National Provider Identifier
1639573132
Registry record updated Sep 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301007439 Issued in MI
Practice address
234 Michigan Ave
East Lansing, MI 48823-4215
Phone
(517) 337-6545
Fax
(517) 337-3010
NPI assigned
Oct 14, 2014
Last updated
Sep 3, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301007439 MI Primary

Addresses

Primary practice location

234 Michigan Ave
East Lansing, MI 48823-4215

Mailing address

234 Michigan Ave
East Lansing, MI 48823-4215
Phone (517) 337-6545

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
I20210830001497 MI Practitioner - Clinical Psychologist 2567867534 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301007439MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Psychological Services PC CurrentSince Sep 1, 2021 Accepting new patients
Comprehensive Psychological Service, PLLC CurrentSince Sep 1, 2021 Accepting new patients

Locations

2720 E Lansing Dr
East Lansing, MI 48823
Phone (517) 337-2900

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, 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": "1413244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1639573132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 MICHIGAN AVE",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488234215",
            "telephone_number": "517-337-6545",
            "fax_number": "517-337-3010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 MICHIGAN AVE",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488234215",
            "telephone_number": "517-337-6545",
            "fax_number": "517-337-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON",
        "first_name": "SIGRID",
        "middle_name": "JULIAN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-14",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301007439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

Verify at the official NPI Registry.