Gabriana Jewel Dickerson

Individual provider Active NPI Mental Health Counselor · Athol, MA

NPI 1104383462 · NPPES record last updated Sep 28, 2023

Key facts

NPI
1104383462
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
2033 Main St
Athol, MA 01331-3535
Phone
(978) 249-9490
NPI assigned
Feb 22, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

2033 Main St
Athol, MA 01331-3535

Mailing address

2033 Main St
Athol, MA 01331-3535
Phone (978) 249-9490

Other providers in Athol, MA

All providers in Athol, MA · Mental Health Counselor in Massachusetts

Sources for this page

Verify at the official NPI Registry.