Natalia Diiacovo

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4704352369 Issued in MI

Practice address

43825 Michigan Ave
Canton, MI 48188-2551

Phone

(734) 397-3088

NPI assigned

Apr 17, 2021

Last updated

Oct 5, 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1618617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1881275212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47125 STONECREST DR",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481703432",
            "telephone_number": "734-474-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43825 MICHIGAN AVE",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481882551",
            "telephone_number": "734-397-3088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIIACOVO",
        "first_name": "NATALIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-17",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704352369",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704352369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dianne Hartman PLLC
• Jamie Dicarlo, PTA
• Ryan Dickerson, RBT
• Erin M Dickinson, MS, RD
• Stacy Lynn Dickinson, BSW
• Amber M Dillon, LMSW, LCSW
• Patricia Dimaria
• Direct Optical of Canton, LLC
• Divine Arrival LLC
• Divinecare Home Health Care

• Psychiatric/Mental Health Nurse Practitioner in Canton, MI
• Providers in Canton, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; 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.