An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
| Specialty | Taxonomy Code | |
|---|---|---|
| * | Adolescent and Children Mental Health | 261QM0855X |
| Adult Mental Health | 261QM0850X |
* Indicates primary specialty
| NPI Number | 1598217614 |
| Legal business name LBN |
SUSAN E DIETERICH PHD LLC |
| Authorized official | SUSAN DIETERICH - (PSYCHOLOGIST) |
| Entity | Organization |
| Organization subpart | No |
| Enumeration date | 10/25/2016 |
| Last updated | 10/25/2016 - About 10 years ago |
| Sole proprietor1 | Not specified |
| Identifiers |
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1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.
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