Tyiana Renee Dickerson

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

3018 Old Minden Rd Ste 1117
Bossier City, LA 71112-2497

Phone

(318) 746-1935

NPI assigned

May 20, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Mildred Eual Center Inc

  dba Meci

  • Community/Behavioral Health Agency
  • Bossier City, LA
  • NPI 1861858516
  NPD (past)
• Unlimited Alternatives to Change, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bossier City, LA
  • NPI 1053731232

  Community/Behavioral Health

  NPD (past)

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

{
    "created_epoch": "1463702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557360000000",
    "number": "1295182194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 SCHOOLHOUSE RD",
            "address_2": "APT. 5",
            "city": "CLOUTIERVILLE",
            "state": "LA",
            "postal_code": "714162019",
            "telephone_number": "504-512-0778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3018 OLD MINDEN RD STE 1117",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711122497",
            "telephone_number": "318-746-1935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "TYIANA",
        "middle_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-20",
        "last_updated": "2019-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desiree Earle Counseling and Consultation
• Valerie K Deville, AGPCNP-C
• Wayne Dial
• Diamond Chiropractic Heath Center LLC
• Diane W Whaley on the Go Optical Service
• Tessa M Didier
• Ronda Jeannette Dietzel, PHARMD
• Savannah Claire Digiacomo, MCD, CCC-SLP
• Taro Miwa Digney, DDS
• Disability Management Group, LLC

• Case Manager/Care Coordinator in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Case Manager/Care Coordinator in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; 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.