Individual provider Active NPI

Michelle Trahan Dyer, APRN, APMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lake Charles, LA
National Provider Identifier
1790079465
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP06442 Issued in LA
Practice address
748 Bayou Pines East Dr Ste C
Lake Charles, LA 70601-7596
Phone
(337) 602-1462
Fax
(337) 602-1464
NPI assigned
May 30, 2011
Last updated
Jan 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP06442 LA Primary

Addresses

Primary practice location

748 Bayou Pines East Dr Ste C
Lake Charles, LA 70601-7596

Mailing address

748 Bayou Pines East Dr Ste C
Lake Charles, LA 70601-7596
Phone (337) 602-1462

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111004000408 LA Practitioner - Nurse Practitioner 3072785609 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dyer Psychiatric ServicesGroup PAC ID 2668851114, 2 clinicians

Practice addresses (Care Compare)

748 Bayou Pines E Dr
Suite C
Lake Charles, LA 70601-7596
Phone (337) 602-1462

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dyer Psychiatric Services Psychiatric/Mental Health CurrentSince Jun 1, 2022 Accepting new patients
Advanced Psychiatric Services, LLC Past Accepting new patients
Allyson Warshaw, LCSW LLC Past Accepting new patients

Locations

748 Bayou Pines East Dr
Ste C
Lake Charles, LA 70601
Phone (337) 602-1462

Organizations & group practices 3

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": "1306713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1790079465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "748 BAYOU PINES EAST DR STE C",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706017596",
            "telephone_number": "337-602-1462",
            "fax_number": "337-478-9828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "748 BAYOU PINES EAST DR STE C",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706017596",
            "telephone_number": "337-602-1462",
            "fax_number": "337-602-1464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYER",
        "first_name": "MICHELLE",
        "middle_name": "TRAHAN",
        "name_prefix": "Ms.",
        "credential": "APRN, APMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-30",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "LA",
            "license": "AP06442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.