DR. ZACHARY CLAYBORNE DIETRICH PSY.D.
NPI 1104476126
Psychologist in Louisville, KY

Active since September 12, 2019PECOS EnrolledAccepts Medicare Assignment
100 EXECUTIVE PARK STE 103, LOUISVILLE, KY 40207(502) 313-6880 Get Directions Write a Review

NPPES record last updated: September 12, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Zachary Clayborne Dietrich Psy.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ZACHARY CLAYBORNE DIETRICH PSY.D. (NPI 1104476126) is an individual psychologist in Louisville, Kentucky, licensed in Kentucky (252672) and active in the NPI registry since September 2019. He is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1104476126
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameDR. ZACHARY CLAYBORNE DIETRICHCredential: PSY.D.
Location Address100 EXECUTIVE PARK STE 103Louisville, KY 40207-4201
Mailing Address910 Howser RdHenryville, IN 47126-8616 · (502) 807-2481
Sole ProprietorYes
Medical School CMSOtherGraduated 2017
Enumeration DateSeptember 12, 2019
NPI 1104476126 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in KY · 252672
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
100 EXECUTIVE PARK STE 103, Louisville, KY 40207

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Zachary Clayborne Dietrich Psy.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6901238070
PECOS Enrollment IDI20191111001466
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Psychiatric/Mental Health)
100 EXECUTIVE PARK STE 103
LOUISVILLE, KY 40207
Nurse Practitioner (Psychiatric/Mental Health)
100 EXECUTIVE PARK STE 103
LOUISVILLE, KY 40207
Marriage & Family Therapist
100 EXECUTIVE PARK STE 103
LOUISVILLE, KY 40207
Social Worker (Clinical)
100 EXECUTIVE PARK STE 103
LOUISVILLE, KY 40207
Counselor (Professional)
100 EXECUTIVE PARK STE 103
LOUISVILLE, KY 40207
Counselor (Professional)
100 EXECUTIVE PARK STE 103
LOUISVILLE, KY 40207
Social Worker (Clinical)
100 EXECUTIVE PARK STE 103
LOUISVILLE, KY 40207
Nurse Practitioner (Psychiatric/Mental Health)
100 EXECUTIVE PARK STE 103
LOUISVILLE, KY 40207

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Zachary Dietrich's NPI number?

The NPI number for Zachary Dietrich is 1104476126. It was assigned to this individual provider in the NPPES registry on September 12, 2019.

Where is Zachary Dietrich located?

Zachary Dietrich practices at 100 Executive Park Ste 103, Louisville, KY 40207. The listed phone number is (502) 313-6880.

What is Zachary Dietrich's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Zachary Dietrich enrolled in Medicare?

Yes. Zachary Dietrich is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Zachary Dietrich accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan and Ambetter from Meridian list Zachary Dietrich as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Zachary Dietrich was last updated on September 12, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.