Individual provider Active NPI

Wendy Lynn Dickinson, PH.D.

  • Counseling Psychologist
  • Atlanta, GA
National Provider Identifier
1174811319
Registry record updated Jul 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
3256 Issued in GA
Practice address
2964 Peachtree Rd NW
Suite 760
Atlanta, GA 30305-2153
Phone
(678) 463-1092
NPI assigned
Jul 20, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 3256 GA Primary

Addresses

Primary practice location

2964 Peachtree Rd NW
Suite 760
Atlanta, GA 30305-2153

Mailing address

2964 Peachtree Rd NW
Suite 760
Atlanta, GA 30305-2153
Phone (678) 463-1092

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

LicenseStateTypeSpecialty
3256GAMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Counseling Past Accepting new patients
Grow Heal Live Lead LLC Counseling Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1311120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311120000000",
    "number": "1174811319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2964 PEACHTREE RD NW",
            "address_2": "SUITE 760",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303052153",
            "telephone_number": "678-463-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2964 PEACHTREE RD NW",
            "address_2": "SUITE 760",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303052153",
            "telephone_number": "678-463-1092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKINSON",
        "first_name": "WENDY",
        "middle_name": "LYNN",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-20",
        "last_updated": "2011-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "GA",
            "license": "3256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2011; 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.