DIANE HAYWARD WICKHAM (NPI# 1376761684) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376761684 |
| Entity Type | Individual |
| Full Name | DIANE HAYWARD WICKHAM |
| Credential | L.P.C. |
| Practice Address |
26300 Outer Dr. Lincoln Park MI 48146 |
| Practice Telephone | 3133884630 |
| Practice Fax Number | 3133880472 |
| Mailing Telephone | 3133884630 |
| Mailing Fax Number | 3133880472 |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
6401002692 | MI | Behavioral Health & Social Service Providers |
| Street Address |
26300 OUTER DR. |
| City | LINCOLN PARK |
| State | MI |
| Zip Code | 48146 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356967251 | Luisa Sofia Amaya | Behavior Technician | 1360 Porter Ave, Lincoln Park, MI 48146 | 2020-06-17 |
| 1851854129 | Abhi Patel | Physical Therapist | 25050 W. Outer Dr, Ste: 204, Lincoln Park, MI 48146 | 2019-04-12 |
| 1831608827 | Back On Track Physical Therapy LLC | Clinic/Center | 1132 Southfield Road, Lincoln Park, MI 48146 | 2017-09-22 |
| 1326568221 | Priscilla Cano | Social Worker | 1600 Porter, Detroit, MI 48146 | 2017-06-21 |
| 1952650194 | Melissa Margaret Belinc | Psychologist | 26300 Outer Drive, Lincoln Park, MI 48146 | 2012-09-04 |
| 1497011746 | Richard John Daniels | Physical Therapy Assistant | 1538 Morris, Lincoln Park, MI 48146 | 2012-04-11 |
| 1740563261 | Myesha Renee Thurman | Social Worker | 26180 W. Outer Drive, Lincoln Park, MI 48146 | 2011-09-21 |
| 1033491162 | Heidi Bremer | Social Worker | 26180 West Outer Drive, Lincoln Park, MI 48146 | 2011-09-14 |
| 1871823526 | Richard Dale Mott | Counselor | 1564 Arlington, Lincoln Park, LA 48146 | 2009-12-31 |
| 1386801777 | Laura Ann Kaakati-weber | Psychologist | 26184 West Outer Drive, Lincoln Park, MI 48146 | 2008-05-22 |
| Find all providers in zip 48146 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891206751 | Medina Colaku | Counselor | 209 Comly Rd # Aptc16, Lincoln Park, NJ 07035-1126 | 2017-10-18 |
| 1659807501 | Elizabeth Vander Valk | Counselor | 33 Patania Ct, Lincoln Park, NJ 07035-1245 | 2017-05-11 |
| 1215471784 | Rachel Bellow | Counselor | 37 Seminole Ave, Lincoln Park, NJ 07035-2220 | 2016-12-18 |
| 1831680529 | Sherry Lynn Razo | Counselor | 26184 Outer Dr, Lincoln Park, MI 48146-2084 | 2018-05-29 |
| 1528584299 | Je'mille Newby | Counselor | 26184 Outer Dr, Lincoln Park, MI 48146 | 2017-08-15 |
| 1225461957 | Virginia Weaver Harrell | Counselor | 26184 Outer Dr, Lincoln Park, MI 48146-2084 | 2013-08-16 |
| 1487927646 | Pamela L. Tooson | Counselor | 26184 Outer Dr, Lincoln Park, MI 48146-2084 | 2012-02-20 |
| 1124221148 | William Carl Parham | Counselor | 26184 Outer Dr, Lincoln Park, MI 48146-2084 | 2007-06-07 |
| 1275736225 | Richard Smolinski | Counselor | 26184 Outer Dr, Lincoln Park, MI 48146-2084 | 2007-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316548100 | Grey Street Counseling and Wellness Center, LLC | Counselor | 314 Moonlite Court, Clarkston, MI 48348 | 2020-11-06 |
| 1619578549 | Joy Love Telehealth | Counselor | 444 Beach Farm Cir, Highland, MI 48356 | 2020-11-06 |
| 1407457799 | Next Level Counseling and Consulting, LLC | Counselor | 5231 Grayton St, Detroit, MI 48224-2149 | 2020-11-04 |
| 1760082309 | Lauren Alyssa Rainey | Counselor | 46522 Aarons Way, Canton, MI 48188-2323 | 2020-10-30 |
| 1033719679 | Jonelle Reynoso | Counselor | 140 Lyndenglen Dr Apt 208, Ann Arbor, MI 48103-6979 | 2020-10-30 |
| 1659971802 | Lauren Antoinette Long | Counselor | 732 E Grand Blanc Rd, Grand Blanc, MI 48439-1333 | 2020-10-27 |
| 1811596570 | Cynthia Fulkerth | Counselor | 124 W Gates St Ste 203, Bruce Twp, MI 48065-4493 | 2020-10-22 |
| 1730788530 | Ryan Michael De Nike | Counselor | 4710 W Saginaw Hwy Ste 8, Lansing, MI 48917-2654 | 2020-10-22 |
| 1467051201 | Jennifer Joelle Jacobs | Counselor | 3760 Whispering Way Se Apt 204, Grand Rapids, MI 49546-7601 | 2020-10-22 |
| 1669071585 | Carraus Harden | Counselor | 13238 N Norfolk, Detroit, MI 48235-1026 | 2020-10-21 |
| Find all providers with the same taxonomy | ||||
| City | LINCOLN PARK |
| Zip Code | 48146 |
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| 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.