Marnie Smith Dillon, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

954 Issued in AL

Practice address

300 Twining St BLDG 760
Maxwell Afb, AL 36112-6027

Phone

(334) 953-5200

Fax

(334) 953-8607

NPI assigned

Apr 18, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Clark Psychological Associates

  • Cognitive & Behavioral Psychologist
  • Montgomery, AL
  • NPI 1437394103
  NPD (past)

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1801851464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4146 CARMICHAEL COURT",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "36106",
            "telephone_number": "334-409-0210",
            "fax_number": "334-409-0250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 TWINING ST BLDG 760",
            "city": "MAXWELL AFB",
            "state": "AL",
            "postal_code": "361126027",
            "telephone_number": "334-953-5200",
            "fax_number": "334-953-8607"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4146 Carmichael Court",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "AL",
            "postal_code": "36106",
            "country_code": "US",
            "telephone_number": "334-409-0210",
            "fax_number": "334-409-0250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DILLON",
        "first_name": "MARNIE",
        "middle_name": "SMITH",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-18",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05155825",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "710954994",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "283901",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "344168000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "620006996",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FED BCBS",
            "identifier": "051510276",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-AL",
            "identifier": "051001486",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "493012",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jamie Dale Cornett, O.D.
• James A Dauber, PT
• Hector F Davila, MD
• Shana Dawson, NP
• Jacob A Deniakos, D.D.S.
• Tristan Eddy, PHARMD
• Daniel J Efraim, PHARM.D.
• Melissa Nash Everage, NURSE PRACTITIONER
• Alexandria Fava, DMD
• Aillen Ford, LCSW

• Clinical Psychologist in Maxwell Afb, AL
• Providers in Maxwell Afb, AL by specialty
• Clinical Psychologist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; 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.