Carol S Dickerson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW004511 Issued in MO

Practice address

33 E Jackson St
Marshall, MO 65340-2153

Phone

(660) 886-8063

Fax

(660) 886-3051

NPI assigned

May 24, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Carol M Sachse Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Burrell, Inc.

  dba Burrell Behavioral Health

  • Community/Behavioral Health Agency
  • Springfield, MO
  • NPI 1275541740
  NPD (past)
• Curators of the University of Missouri

  dba University Physicians

  • Multi-Specialty Clinic/Center
  • Columbia, MO
  • NPI 1477587152
  NPD (past)

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104871151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7687",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652057687",
            "telephone_number": "573-882-2259",
            "fax_number": "573-884-8526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 E JACKSON ST",
            "city": "MARSHALL",
            "state": "MO",
            "postal_code": "653402153",
            "telephone_number": "660-886-8063",
            "fax_number": "660-886-3051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "CAROL",
        "middle_name": "S",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "SW004511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "324643",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD/BLUE CHOICE",
            "identifier": "127133",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KANSAS MEDICARE",
            "identifier": "K51A688",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "SACHSE",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• D. J. Fahnestock, D. C., P. C.
• Misty Dace
• Lyndsey Brooke Davis
• Dennis Leon Hunter (Marshall Eye Care Center,LLC)
• Brian Devivo
• Jeffery C Diehl, M.D.
• Karla Dora Dobbs, D.O.
• Brenda K Dodds, RN, FNP-C, FNP
• Deanna C Donnell, CNM
• Amber Renee Drumheller, PMHNP-BC

• Clinical Social Worker in Marshall, MO
• Providers in Marshall, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.