DIANE MCCORMACK (NPI# 1376571729) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376571729 |
| Entity Type | Individual |
| Full Name | DIANE MCCORMACK |
| Credential | PH.D. |
| Practice Address |
366 Belanger St Grosse Pointe Farms MI 48236-3334 |
| Practice Telephone | 3138851385 |
| Practice Fax Number | 3138846432 |
| Mailing Telephone | 3138851385 |
| Mailing Fax Number | 3138846432 |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2009-09-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
6301007909 | MI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBSM | 680H247980 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063657120 | Diane Jean Mccormack | Occupational Therapist | 15840 Long Lake Road, Detroit Lakes, MN 56501 | 2008-12-03 |
| Street Address |
366 BELANGER ST |
| City | GROSSE POINTE FARMS |
| State | MI |
| Zip Code | 48236-3334 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093323966 | Khairya Fatouh | Pathology | 22101 Morros Road, Pathology Department, Detroit, Detroit, MI 48236 | 2020-07-16 |
| 1134744998 | Harish Harry Gidda | Internal Medicine | 22201 Moross Rd, Suite 50, Detroit, MI 48236 | 2020-06-08 |
| 1770107443 | Arshan Ali Khan | Internal Medicine | 22101 Moross Rd, Suite 50, Detroit, MI 48236 | 2020-05-29 |
| 1750901658 | Annika Van Wieren | Emergency Medicine | 22101 Moross Road, Emergency Department, Detroit, MI 48236 | 2020-04-21 |
| 1801449483 | Ishaq Azeem Asghar | Student in an Organized Health Care Education/Training Program | 22101 Moross Road, Pathology Department, Detroit, MI 48236 | 2019-07-22 |
| 1295290443 | Ascension St. John Hospital | Dietitian, Registered | 22201 Moross, Ste. 270, Detriot, MI 48236 | 2019-02-01 |
| 1548747413 | Abiodun Adenuga Adefarasin | Pharmacist | 20746 Mack Avenue, Gross Pointe Woods, MI 48236 | 2018-07-24 |
| 1629564042 | Hamza H Khan | Student in an Organized Health Care Education/Training Program | 22201 Moross, Professional Building 2, Suite 70, Detroit, MI 48236 | 2018-07-09 |
| 1235631664 | David Lee Williams | Physical Therapist | 159 Kercheval Avenue, Grosse Pointe Farms, MI 48236 | 2018-03-01 |
| 1164979720 | Memphie Morgan | Licensed Practical Nurse | 91527 Cheshire St., Grosse Pointe, MI 48236 | 2016-09-01 |
| Find all providers in zip 48236 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487050290 | Judy Gilbert | Psychologist | 188 Lakeview Ave, Grosse Pointe Farms, MI 48236-2907 | 2014-11-06 |
| 1548414410 | Mark Rene Desroberts | Psychologist | 159 Kercheval Ave, Grosse Pointe Farms, MI 48236-3610 | 2008-11-05 |
| 1578762795 | Gertride Yvonne Kerns | Psychologist | 131 Kercheval Ave, Grosse Pointe Farms, MI 48236-3629 | 2007-07-17 |
| 1558573154 | Diane Sharon Smith | Psychologist | 119 Kercheval Ave, Grosse Pointe Farms, MI 48236 | 2007-05-04 |
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|---|---|---|---|---|
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| 1538767678 | Up Telehealth, LLC | Psychologist | 228 W Washington St Ste 7, Marquette, MI 49855-4330 | 2020-10-12 |
| 1881292076 | Meaningful Change: Clinical & Consultation Psychology, Pllc | Psychologist | 1861 Woodland Dr, Mount Pleasant, MI 48858-1298 | 2020-10-11 |
| 1902404122 | Dorrean Riley | Psychologist | 19189 Lexington, Redford, MI 48240-2618 | 2020-10-09 |
| 1174130850 | Timber Creek Counseling West LLC | Psychologist | 2976 Ivanrest Ave Sw Ste 215, Grandville, MI 49418-1440 | 2020-09-28 |
| Find all providers with the same taxonomy | ||||
| City | GROSSE POINTE FARMS |
| Zip Code | 48236 |
Please comment or provide details below to improve the information on DIANE MCCORMACK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.