Active NPI
Cody William Dickson, PHD, LPC, NCC
- Professional Counselor
- Lubbock, TX
National Provider Identifier
1124436035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 69897
- Practice address
- 3805 22ND St Ste 1C
Lubbock, TX 79410-1142 - Phone
- (806) 252-6633
- NPI assigned
- Jul 24, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 5222 | NE | |
| Professional Counselor | 101YP2500X | 69897 | TX | Primary |
Addresses
Primary practice location
3805 22ND St Ste 1C
Lubbock, TX 79410-1142
Mailing address
4510 Ironton Ave Apt 3201
Lubbock, TX 79407-3783
Phone (806) 252-6633
Other practice location 1
6554 92nd St
Lubbock, TX 79424-6773
Phone (806) 252-6633
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5222 | Other | NE | NEBRASKA DHHS LICENSURE UNIT |
| 338488501 | Medicaid | TX | |
| 69897 | Other | TX | TEXAS STATE BOARD OF EXAMINERS OF PROFESSIONAL COUNSELORS |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5222 | NE | MD | Mental Health Counselor |
| 69897 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568332800000",
"number": "1124436035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4510 IRONTON AVE APT 3201",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794073783",
"telephone_number": "806-252-6633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3805 22ND ST STE 1C",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794101142",
"telephone_number": "806-252-6633"
}
],
"practiceLocations": [
{
"address_1": "6554 92nd St",
"address_purpose": "LOCATION",
"city": "Lubbock",
"state": "TX",
"postal_code": "794246773",
"country_code": "US",
"telephone_number": "806-252-6633",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DICKSON",
"first_name": "CODY",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "PHD, LPC, NCC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-07-24",
"last_updated": "2019-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NE",
"license": "5222",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "69897",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEBRASKA DHHS LICENSURE UNIT",
"identifier": "5222",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "338488501",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS STATE BOARD OF EXAMINERS OF PROFESSIONAL COUNSELORS",
"identifier": "69897",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.