Individual provider Active NPI

Dima Swaidan, PSYD, LP

  • Psychologist
  • Plymouth, MI
National Provider Identifier
1962051425
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
496 W Ann Arbor TRL Ste 106
Plymouth, MI 48170-6262
Phone
(734) 392-4130
NPI assigned
Sep 8, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301017972 MI
Clinical Psychologist 103TC0700X 6301019156 MI
Psychologist 103T00000X Primary

Addresses

Primary practice location

496 W Ann Arbor TRL Ste 106
Plymouth, MI 48170-6262

Mailing address

47526 Clipper St Unit 702094
Plymouth, MI 48170-7118
Phone (734) 386-0252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230907000985 MI Practitioner - Clinical Psychologist 7214391481 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

47526 Clipper St
Unit 702094
Plymouth, MI 48170-7118
Phone (734) 392-4130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6301017972MIMDClinical Psychologist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1567900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1962051425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47526 CLIPPER ST UNIT 702094",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481707118",
            "telephone_number": "734-386-0252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 W ANN ARBOR TRL STE 106",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706262",
            "telephone_number": "734-392-4130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWAIDAN",
        "first_name": "DIMA",
        "name_prefix": "Dr.",
        "credential": "PSYD, LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-08",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301017972",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301019156",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

Verify at the official NPI Registry.