Smith, Diane Sharon
Smith, Diane Sharon is an sole proprietor health care provider with primary practice located at 119 Kercheval Ave , Grosse Pointe Farms MI 48236. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Smith, Diane Sharon can be contacted via phone (313) 881-2010.Contact Information
Primary practice address
119 Kercheval Ave
Grosse Pointe Farms MI 48236
Phone: (313) 881-2010
Fax: (313) 882-7424
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 6801017113 | Michigan |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 6301007629 | Michigan |
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | 110675 | Michigan |
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 364SP0808X | 110675 | Michigan |
Profile Details
| NPI number | 1558573154 |
|---|---|
| LBN Legal business name | Smith, Diane Sharon |
| Credentials | PHD MSW APRN BC CNS |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 4th, 2007 |
| Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558573154 | NPPES |
| Michigan | Other | 6301007629 | CLINICAL PSYCHOLOGIST |
| Michigan | Other | 5008661290 | CLINICAL PSYCHOLOGIST |
| Michigan | Other | 6801017113 | CLINICAL PSYCHOLOGIST |
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