Active NPI
Michael Bruce Deitch, PHD LPC
- Professional Counselor
- The Woodlands, TX
National Provider Identifier
1760521165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC 9354
- Practice address
- 8701 New Trails Dr
Suite 150
The Woodlands, TX 77381-4253 - Phone
- (281) 367-1015
- Fax
- (281) 367-1966
- NPI assigned
- Feb 5, 2007
- Last updated
- Jun 26, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC 9354 | TX | Primary |
| Professional Counselor | 101YP2500X | NU |
Addresses
Primary practice location
8701 New Trails Dr
Suite 150
The Woodlands, TX 77381-4253
Mailing address
8701 New Trails Dr
Suite 150
The Woodlands, TX 77381-4253
Phone (281) 367-1015
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6511LC | Other | TX | BLUE CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC 9354 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Millennium Physicians Association, PLLC | Past | Accepting new patients |
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
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.
-
dba Millennium Oncology
- Multi-Specialty Clinic/Center
- The Woodlands, TX
- NPI 1255397733
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435276800000",
"number": "1760521165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8701 NEW TRAILS DR",
"address_2": "SUITE 150",
"city": "THE WOODLANDS",
"state": "TX",
"postal_code": "773814253",
"telephone_number": "281-367-1015",
"fax_number": "281-367-1966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8701 NEW TRAILS DR",
"address_2": "SUITE 150",
"city": "THE WOODLANDS",
"state": "TX",
"postal_code": "773814253",
"telephone_number": "281-367-1015",
"fax_number": "281-367-1966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEITCH",
"first_name": "MICHAEL",
"middle_name": "BRUCE",
"name_prefix": "Mr.",
"credential": "PHD LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-05",
"last_updated": "2015-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "LPC 9354",
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "6511LC",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in The Woodlands, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.