Gayle Lynette Dickerson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.016776 Issued in IL

Practice address

10735 S Cicero Ave Ste 208
Oak Lawn, IL 60453-6214

Phone

(708) 424-0001

Fax

(708) 424-1394

NPI assigned

Aug 4, 2018

Last updated

Aug 4, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 27, 2024 through Mar 27, 2028

Medicare enrollment (NPD)

Not 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.

• Center for Psychological Services - Oak Lawn LTD

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Oak Lawn, IL
  • NPI 1386604577
  NPD (past)
• Center for Psychological Services,LTD

  • Mental Health Counselor
  • Oak Lawn, IL
  • NPI 1285874966
  NPD (past)

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

{
    "created_epoch": "1533340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533340800000",
    "number": "1205314861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5858 N MAGNOLIA AVE # 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606603419",
            "telephone_number": "773-710-6080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10735 S CICERO AVE STE 208",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604536214",
            "telephone_number": "708-424-0001",
            "fax_number": "708-424-1394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "GAYLE",
        "middle_name": "LYNETTE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-04",
        "last_updated": "2018-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.016776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alaaeldin Diab
• Dialysis Care Center Oak Lawn LLC
• Diamond Dialysis of Oak Lawn
• Mauricio Diaz Ayala
• Jaina Cristina Diaz-Kelly, MD
• Nicholas M Difilippo, DO
• Digitrace Care Services, Inc
• Kimberley Jo Dilley, MD
• Elena Dillmann, DO
• Melissa Dillon, DPT

• Clinical Social Worker in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.