Samantha Renee Dickow, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C.1801517 Issued in OH

Practice address

4430 Missouri Ave
Fort Leonard Wood, MO 65473-9098

Phone

(440) 567-6681

NPI assigned

May 15, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Counseling Center of West Louisiana

  • Marriage & Family Therapist
  • Leesville, LA
  • NPI 1184392813
  NPD (past)

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

{
    "created_epoch": "1526342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1083104152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4430 MISSOURI AVE",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654739098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4430 MISSOURI AVE",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654739098",
            "telephone_number": "440-567-6681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKOW",
        "first_name": "SAMANTHA",
        "middle_name": "RENEE",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-15",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.1801517",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OH",
            "license": "M.1700073-TRNE",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelyn Deaderick, APRN, FNP-C
• Nathan D Dederman, OD, FAAO
• Jennifer Lynn Degon, ABOC
• Tyler Deloach, PHARMD
• Jessie Marie Dickinson, RD, LD
• Angela Renee Diebal-Lee, DPT, DSC, OCS, SCS
• Teresa Anne Distler, NP-C
• Nicholas Dobbs
• Kodjo Adam Dodo, RD
• Brock Justin Dodsworth, PTA

• Mental Health Counselor in Fort Leonard Wood, MO
• Providers in Fort Leonard Wood, MO by specialty
• Mental Health Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; 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.