Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Carly Dietrich, LMSW

Individual provider Social Worker · NPI 1548874373

Carly Dietrich, LMSW is a Clinical Social Worker in Grand Rapids, Michigan. Qualified in 2020, 6 years ago. Works from 2 locations. Licensed in Michigan.

Years since qualifying
6
Licensed in
MI
In the registry since
2020
Specialties on file
2
What do these letters mean?
LMSW — Licensed Master Social Worker
A master's-level social worker, usually practising under supervision.

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Practice location Address checks out

790 Fuller Ave NE
Grand Rapids, MI 49503-1918
Phone: (616) 336-3909
Fax: (616) 336-8830
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

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

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 6801120001 (MI)
Social Worker Taxonomy 104100000X · Licence 6801107507 (MI)

Record details

NPI number1548874373
Entity typeIndividual (Type 1)
GenderFemale
Credentials LMSW
Sole proprietorNo
NPI enumeratedAugust 31, 2020
Last updated in NPPESApril 17, 2026
Certification dateApril 17, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Accepts Medicare assignment Not indicated

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