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. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 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:
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Health care specialties

SpecialtyCodeLicense #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 Sep 11th, 2025 - about last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558573154 NPPES
Michigan Other 6301007629 CLINICAL PSYCHOLOGIST
Michigan Other 5008661290 CLINICAL PSYCHOLOGIST
Michigan Other 6801017113 CLINICAL PSYCHOLOGIST

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