MEDICARE: DINES CONSULTING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	6301002453	MI

General Provider Information

NPI Number	:	1922518810
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DINES CONSULTING LLC

Provider Business Mailing Address
First Line	:	PO BOX 10
Second Line	:
City	:	MASON
State	:	MI
Zip	:	48854-0010
Country	:	US
Telephone Number	:	517-676-9788
Fax Number	:

Provider Business Practice Location Address
First Line	:	1066 APPLEGATE LN
Second Line	:
City	:	EAST LANSING
State	:	MI
Zip	:	48823-2118
Country	:	US
Telephone Number	:	517-290-7672
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING
Name	:	MARYBETH HOUPT
Credential	:
Telephone Number	:	517-676-9797

Provider Enumeration Date	:	10/04/2017
Last Update Date	:	12/09/2025

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Directions to “DINES CONSULTING LLC ” Practice Location

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