Individual provider · Type 1 NPI

Carly Dietrich, LMSW

Clinical Social Worker · Grand Rapids, MI

NPI number 1548874373 Active

Practice location

790 Fuller Ave NE
Grand Rapids, MI 49503-1918

Call (616) 336-3909 Map

Fax (616) 336-8830

Other practice locations

  • 610 S Burdick St, Kalamazoo, MI 49007-5221 · (269) 381-3700

Specialties and licenses

TaxonomyCodeLicense
Social Worker 104100000X6801107507 (MI)
Clinical Social Worker Primary 1041C0700X6801120001 (MI)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1548874373

Carly Dietrich, LMSW's National Provider Identifier is 1548874373, issued on Aug 31, 2020. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Grand Rapids, MI. The record was last updated on Apr 17, 2026.