Charly Dolan

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6362009794 Issued in MI

Practice address

323 E Grand River Ave
Howell, MI 48843-2322

Phone

(989) 510-7626

NPI assigned

Jan 27, 2021

Last updated

Aug 23, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in MI

Enrollment records 1

Specialty

Clinical Psychologist

Education

Michigan State University College of Human Medicine, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Clinton County Medical Center Psychological Services PLLC

  • Mental Health Counselor
  • Saint Johns, MI
  • NPI 1871931055
  Medicare reassignment NPD
• Clinton County Medical Center Psychological Services PLLC

  • Family Medicine Physician
  • Saint Johns, MI
  • NPI 1538973144

  Clinical

  NPD

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

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1821689522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27777 INKSTER RD STE 100",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483345312",
            "telephone_number": "248-436-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 E GRAND RIVER AVE",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488432322",
            "telephone_number": "989-510-7626"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27777 Inkster Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Farmington Hills",
            "state": "MI",
            "postal_code": "483345312",
            "country_code": "US",
            "telephone_number": "248-436-4400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOLAN",
        "first_name": "CHARLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-27",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6362009794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Dimeglio
• Sarah Dirosa, CRNA
• Gary Robert Distefano, D.D.S.
• Laurie Ann Dixon, MD
• Alexis Marja Joy Doan
• Danielle Bovee Domzalski, LLBSW, QMRP
• William R Donahue, MA
• Heather Leann Dorais, OTRL
• Dore Counseling PLLC
• Diane Dore, LMSW

• Clinical Psychologist in Howell, MI
• Providers in Howell, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.