Individual provider Active NPI

Anna Dickinson

  • Mental Health Counselor
  • Conway, SC
National Provider Identifier
1104593201
Registry record updated Sep 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
9698 Issued in SC
Practice address
800 Legion St Ste 200B
Conway, SC 29526-4825
Phone
(843) 448-4820
NPI assigned
Aug 26, 2021
Last updated
Sep 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 9698 SC Primary

Addresses

Primary practice location

800 Legion St Ste 200B
Conway, SC 29526-4825

Mailing address

1772 Vereen Rd
Aynor, SC 29511-6804

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adickinson1@liberty.edu

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9698SCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Tap in Counseling CurrentSince Aug 4, 2024 Accepting new patients
Coastal Samaritan Counseling Center CurrentSince Aug 29, 2021 Accepting new patients

Locations

901 N Kings Hwy
Myrtle Beach, SC 29577
Phone (843) 448-4820

Interoperability endpoints

  • Direct secure messaging: adickinson1@liberty.edu

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790294400000",
    "number": "1104593201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1772 VEREEN RD",
            "city": "AYNOR",
            "state": "SC",
            "postal_code": "295116804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 LEGION ST STE 200B",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295264825",
            "telephone_number": "843-448-4820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKINSON",
        "first_name": "ANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-26",
        "last_updated": "2026-09-25",
        "certification_date": "2026-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "9698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adickinson1@liberty.edu",
            "affiliation": "N",
            "address_1": "901 N Kings Hwy",
            "city": "Myrtle Beach",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295773722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Conway, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2026; 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.