Healthcare Provider Details

I. General information

NPI: 1902760903
Provider Name (Legal Business Name): DANA DICKEN LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2025
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6206 W SAGINAW HWY
LANSING MI
48917-2496
US

IV. Provider business mailing address

156 WINDING WOOD WAY
BATTLE CREEK MI
49014-7819
US

V. Phone/Fax

Practice location:
  • Phone: 269-245-1264
  • Fax:
Mailing address:
  • Phone: 269-245-1264
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801121138
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: