Dana Ticker, B.A.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

4310 NE Killingsworth St
Portland, OR 97218-1404

Phone

(503) 535-1181

NPI assigned

Sep 18, 2012

Sex

Female

Sole proprietor

No

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

Enrolled in OR

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

Marriage and Family Therapist

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rogue Holistic TherapyGroup PAC ID 1456768035, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Arts

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 and National Provider Directory roles.

• Rogue Holistic Therapy

  • Clinical Social Worker
  • Medford, OR
  • NPI 1881285658
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1347926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347926400000",
    "number": "1235489154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 SW WASHINGTON ST",
            "address_2": "PO BOX 3007",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4310 NE KILLINGSWORTH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972181404",
            "telephone_number": "503-535-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICKER",
        "first_name": "DANA",
        "credential": "B.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-18",
        "last_updated": "2012-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robin Lynn Tibbals, LMT
• Alheli Tica-Figueroa, MA
• Brittney Tice, RN BSN
• Emma Louise Tice
• Gracen Tichelaar
• Suzanne Gail Tiddy, LCSW
• Cathy Jean Tidland
• Brandy Lee Tidwell, PHD
• Justin Alan Tidwell, DPM
• Khalia Tidwell

• Marriage & Family Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Marriage & Family Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2012; 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.