DR. DUSTIN MARSH (NPI# 1407150295) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407150295 |
| Entity Type | Individual |
| Full Name | DR. DUSTIN MARSH |
| Credential | PSYD |
| Practice Address |
19044 Outer Dr Dearborn MI 48128 |
| Mailing Address |
19044 Outer Dr Dearborn MI 48128-1862 |
| Practice Telephone | 2136636862 |
| Mailing Telephone | 2136636862 |
| Enumeration Date | 2011-01-07 |
| Last Update Date | 2020-03-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | 6301017547 | MI | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
6301018274 | MI | Behavioral Health & Social Service Providers |
| N | 172V00000X | Community Health Worker | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | LIMITED LICENSE PSYCHOLOGIST - DOCTORAL | 6301017547 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 441 Cheney St, Reno, NV 895020911 | 7753224223 |
| Street Address |
19044 OUTER DR |
| City | DEARBORN |
| State | MI |
| Zip Code | 48128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467942219 | Mahmoud Farhat | Dentist | 18590 Outer Dr, Dearborn, MI 48128 | 2018-05-17 |
| 1730607474 | Gentle Hands Direct Care Services, Inc. | Chore Provider | 6659 Schaefer Hwy, Ste. 103, Dearborn, MI 48128 | 2017-09-01 |
| 1396095824 | Corey S. Farber, Pllc | Dentist | 23919 Ford Road, Dearborn, MI 48128 | 2012-09-12 |
| 1184987075 | Yasser Alali | Dentist | 430 North Telegraph Road, Dearborn, MI 48128 | 2012-06-17 |
| 1841573425 | Apple Transportation LLC | Non-emergency Medical Transport (VAN) | 2000 Lafayette, Dearborn, MI 48128 | 2011-09-21 |
| 1619205028 | Michigan-greenfield Urgent Care Pllc | Clinic/Center | 24355 Ford Rd, Dearborn, MI 48128 | 2009-11-23 |
| 1295905065 | Julius Frank Chikos | Dentist | 21775 Wildwood Street, Dearborn, MI 48128 | 2008-03-07 |
| 1003974155 | Walter Knysz Jr. | Dentist | 23401 Ford Road, Dearborn, MI 48128 | 2006-12-04 |
| 1902983703 | Fadi Ahmad Sobh | Pharmacist | 1745 N Silvery Ln, Dearborn, MI 48128 | 2006-11-01 |
| 1255425740 | Nicole Simms | Contractor | 1009 Drexel, Dearborn, MI 48128 | 2006-10-02 |
| Find all providers in zip 48128 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417575762 | Authenticity Psychological Services | Psychologist | 24314 Cherry Hill St, Dearborn, MI 48124-1358 | 2020-07-13 |
| 1144798216 | Janelle A Smith | Psychologist | 2881 Monroe St # 201, Dearborn, MI 48124-3475 | 2018-11-07 |
| 1881178747 | Sarah Chehab | Psychologist | 835 Mason St Suite 220b, Dearborn, MI 48124 | 2018-09-17 |
| 1851696488 | Ellen Louise Keyt | Psychologist | Counseling & Resource Center of Dearborn, 19855 W. Outer Drive, Dearborn, MI 48124 | 2011-01-12 |
| 1649574526 | Tiffany Zlatich Tuttle | Psychologist | 19855 West Outer Dr Ste 104w, Dearborn, MI 48124-2022 | 2011-01-06 |
| 1689984213 | Justin Wayne Peer | Psychologist | 1 Parklane Blvd Ste 1210e, Dearborn, MI 48126-4283 | 2010-10-17 |
| 1952637126 | Melissa Marie Farrell | Psychologist | 1 Parklane Blvd, Dearborn, MI 48126 | 2009-10-23 |
| 1558594283 | George Psychological Services PC | Psychologist | 2314 Monroe, Dearborn, MI 48124-3045 | 2009-08-28 |
| 1063663714 | Maritaconstance Supan | Psychologist | 934 Mason St, Dearborn, MI 48124-2215 | 2008-09-30 |
| 1588710222 | Manuel Alexander Manrique | Psychologist | 22967 Outer Dr, Dearborn, MI 48124-4248 | 2007-01-26 |
| Find all providers in DEARBORN | ||||
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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.