Individual provider Active NPI

Gail Linda Dietrick, M.A., L.M.H.C.

  • Mental Health Counselor
  • New Bedford, MA
National Provider Identifier
1801839436
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6058 Issued in MA
Practice address
1061 Pleasant St
New Bedford, MA 02740-6728
Phone
(508) 996-8572
Fax
(508) 991-8618
NPI assigned
Jun 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6058 MA Primary

Addresses

Primary practice location

1061 Pleasant St
New Bedford, MA 02740-6728

Mailing address

749 Head of the Bay Rd
Unit #S-13
Buzzards Bay, MA 02532-2150
Phone (508) 759-6870

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)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6058MAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801839436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "749 HEAD OF THE BAY RD",
            "address_2": "UNIT #S-13",
            "city": "BUZZARDS BAY",
            "state": "MA",
            "postal_code": "025322150",
            "telephone_number": "508-759-6870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 PLEASANT ST",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "027406728",
            "telephone_number": "508-996-8572",
            "fax_number": "508-991-8618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETRICK",
        "first_name": "GAIL",
        "middle_name": "LINDA",
        "name_prefix": "Ms.",
        "credential": "M.A., L.M.H.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "6058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bedford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.