Active NPI
Everett T Dickerson, PHD
- Mental Health Counselor
- Wilmington, DE
National Provider Identifier
1215059332
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- PC0000911
- Practice address
- 216 S Union St
Wilmington, DE 19805-3857 - Phone
- (301) 391-0508
- NPI assigned
- Apr 6, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 37PC00708500 | NJ | |
| Mental Health Counselor | 101YM0800X | 7934-MH-CC | MA | |
| Professional Counselor | 101YP2500X | PC007573 | PA | |
| Counseling Psychologist | 103TC1900X | |||
| Clinical Child & Adolescent Psychologist | 103TC2200X | |||
| Mental Health Counselor | 101YM0800X | PC0000911 | DE | Primary |
Addresses
Primary practice location
216 S Union St
Wilmington, DE 19805-3857
Mailing address
216 S Union St
Wilmington, DE 19805-3857
Phone (302) 391-0508
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PC0000911 | DE | MD | Mental Health Counselor |
| 7934-MH-CC | MA | MD | Mental Health Counselor |
| 37PC00708500 | NJ | MD | Mental Health Counselor |
| PC007573 | PA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649894400000",
"number": "1215059332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "216 S UNION ST",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198053857",
"telephone_number": "302-391-0508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "216 S UNION ST",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198053857",
"telephone_number": "301-391-0508"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKERSON",
"first_name": "EVERETT",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-06",
"last_updated": "2022-04-14",
"certification_date": "2022-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NJ",
"license": "37PC00708500",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "7934-MH-CC",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "PA",
"license": "PC007573",
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "DE",
"license": "PC0000911",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.