Individual provider Active NPI

June Faith Dickerson, MA, LCPC

  • Professional Counselor
  • Camp Springs, MD
National Provider Identifier
1245857713
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC12755 Issued in MD
Practice address
5869 Allentown Rd
Camp Springs, MD 20746-4548
Phone
(301) 433-8777
NPI assigned
Jul 1, 2020
Last updated
Jun 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LGP10552 MD
Professional Counselor 101YP2500X LC12755 MD Primary

Addresses

Primary practice location

5869 Allentown Rd
Camp Springs, MD 20746-4548

Mailing address

7601 Paula CT
Brandywine, MD 20613-5739
Phone (202) 251-2211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20240207000622 MD Practitioner - Mental Health Counselor 0941643969 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LGP10552MDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Safe Harbor Christian Counseling LLC Professional CurrentSince Jan 2, 2024 Accepting new patients
Safe Harbor Behavioral Care, LLC Mental Health CurrentSince Jan 2, 2024 Accepting new patients
Safe Harbor Christian Counseling Professional Past Accepting new patients

Locations

1208 E Churchville Rd
Ste 300
Bel Air, MD 21014
Phone (410) 838-9500

11600 Cedarville Rd
Brandywine, MD 20613
Phone (301) 262-2270

8040 Woodyard Rd
Clinton, MD 20735

2 Post Office Rd
Ste 1A
Waldorf, MD 20602

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1593561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1245857713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7601 PAULA CT",
            "city": "BRANDYWINE",
            "state": "MD",
            "postal_code": "206135739",
            "telephone_number": "202-251-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5869 ALLENTOWN RD",
            "city": "CAMP SPRINGS",
            "state": "MD",
            "postal_code": "207464548",
            "telephone_number": "301-433-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "JUNE",
        "middle_name": "FAITH",
        "credential": "MA, LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-01",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LGP10552",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC12755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Springs, MD

Sources for this page

Verify at the official NPI Registry.