Michael A Dickson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LCSW - 28518 Issued in ID

Practice address

8100 W Emerald St Ste 150
Boise, ID 83704-9057

Phone

(208) 375-0752

Fax

(208) 375-0796

NPI assigned

Nov 8, 2007

Last updated

Nov 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Michael A Dickson Professional name

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Bridgeway Health Services LLCGroup PAC ID 0244462745, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bridgeway Health Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Eagle, ID
  • NPI 1619231784
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194480000000",
    "number": "1114107042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 W EMERALD ST STE 150",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049057",
            "telephone_number": "208-375-0752",
            "fax_number": "208-375-0796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 W EMERALD ST STE 150",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049057",
            "telephone_number": "208-375-0752",
            "fax_number": "208-375-0796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKSON",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-08",
        "last_updated": "2007-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ID",
            "license": "ACADC - 76",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCSW - 28518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "DICKSON",
            "middle_name": "A",
            "credential": "LCSW - ACADC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Michael Dean Dickens, R.PH.
• Gregory Dickerson, LCSW
• Kimberly A Dickey, OT
• Kyla Maria Dickey, PHARMD.
• Daniel Jackson Dickman, D.O.
• Sue Soroor Didehban
• Didehbans Limited (Pearlevision)
• Amber Jean Diehl, LMSW
• Scott Diehl
• Charles Diemart, LPC

• Mental Health Counselor in Boise, ID
• Providers in Boise, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.