Amy Elizabeth Dickson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW16050 Issued in FL

Practice address

1260 S MLK Jr Ave Ste D
Clearwater, FL 33756

Phone

(813) 416-1406

NPI assigned

Mar 12, 2019

Last updated

Oct 20, 2020By 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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Palm Harbor Family Counseling Center

  • Adolescent and Children Mental Health Clinic/Center
  • Palm Harbor, FL
  • NPI 1255734935
  NPD (past)

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

{
    "created_epoch": "1552348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1285192989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4107 W SPRUCE ST",
            "address_2": "STE 100",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336072346",
            "telephone_number": "813-636-8811",
            "fax_number": "813-636-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 S MLK JR AVE STE D",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "33756",
            "telephone_number": "813-416-1406"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 Alternate 19 N",
            "address_2": "Suite C",
            "address_purpose": "LOCATION",
            "city": "Palm Harbor",
            "state": "FL",
            "postal_code": "34683",
            "country_code": "US",
            "telephone_number": "727-254-9183",
            "fax_number": "888-345-7010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4107 W Spruce St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336072346",
            "country_code": "US",
            "telephone_number": "813-636-8811",
            "fax_number": "813-636-8855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKSON",
        "first_name": "AMY",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-12",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW16050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102814800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELF-PAY",
            "identifier": "84194",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diamond Business Ventures, Inc (Zounds Hearing of Tampa Bay)
• Diana Summers Denta
• Alejandra Diaz, PHARMD.
• Neisa I Diaz, MD
• Allison Page Dickson, OD
• Laurine Sandy Severine Dicosimo, PCD(DONA)
• Danielle Eugena Dicosola
• Michael V Didonna, DO
• Diehl Chiropractic Inc
• Nathan Jerold Diehl, PA

• Clinical Social Worker in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; 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.