Carl Dickerson, Edd, LPC Counseling and Consulting

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

CARL DICKERSON, EDD, LPC COUNSELING AND CONSULTING

Practice address

1410 Vinery Ave
Cumming, GA 30041-9716

Phone

(678) 431-2070

Fax

(470) 281-5711

NPI assigned

Dec 28, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Carl T. Dickerson, EDD, LPCNPI 1215157045

Title

Owner

Phone

(678) 431-2070

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carl Thomas Dickerson, LPC

  • Professional Counselor
  • Cumming, GA
  • NPI 1215157045
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1545955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714694400000",
    "number": "1013489178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1595 PEACHTREE PKWY",
            "address_2": "SUITE 204, #227",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "30041",
            "telephone_number": "678-431-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 VINERY AVE",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300419716",
            "telephone_number": "678-431-2070",
            "fax_number": "470-281-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARL DICKERSON, EDD, LPC COUNSELING AND CONSULTING",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-28",
        "last_updated": "2024-05-03",
        "certification_date": "2024-04-24",
        "status": "A",
        "authorized_official_last_name": "DICKERSON",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-431-2070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "EDD, LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI FOR THE PROVIDER",
            "identifier": "1215157045",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1215157045",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Cumming, GA
• Providers in Cumming, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.