Stacy Lynn Dickinson, BSW

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Practice address

8142 Honeytree Blvd
BLDG. 61
Canton, MI 48187-4109

Phone

(734) 414-1795

Fax

(734) 451-5410

NPI assigned

Feb 19, 2010

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Personalized Nursing Light House Inc

  • PACE Provider Organization
  • Farmington Hills, MI
  • NPI 1346684420
  NPD (past)

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

{
    "created_epoch": "1266537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266537600000",
    "number": "1821310707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "563 ALLEN RD",
            "address_2": "LOT #1",
            "city": "MILAN",
            "state": "MI",
            "postal_code": "481601516",
            "telephone_number": "734-323-1598",
            "fax_number": "734-451-5410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8142 HONEYTREE BLVD",
            "address_2": "BLDG. 61",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481874109",
            "telephone_number": "734-414-1795",
            "fax_number": "734-451-5410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKINSON",
        "first_name": "STACY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "BSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-19",
        "last_updated": "2010-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diamond Sweetness
• Dianne Hartman PLLC
• Jamie Dicarlo, PTA
• Ryan Dickerson, RBT
• Erin M Dickinson, MS, RD
• Natalia Diiacovo
• Amber M Dillon, LMSW, LCSW
• Patricia Dimaria
• Direct Optical of Canton, LLC
• Divine Arrival LLC

• Substance Abuse Rehabilitation Facility in Canton, MI
• Providers in Canton, MI by specialty
• Substance Abuse Rehabilitation Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2010; 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.