Individual provider Active NPI

Robert Golden-Dick, MA, NCC, LPC

  • Professional Counselor
  • Phoenix, AZ
National Provider Identifier
1295412153
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC-22252 Issued in AZ
Practice address
3864 N 27TH Ave
Phoenix, AZ 85017-4703
Phone
(602) 685-6000
Fax
(602) 212-6250
NPI assigned
Jul 3, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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 LPC-22252 AZ
Professional Counselor 101YP2500X LPC-22252 AZ Primary

Addresses

Primary practice location

3864 N 27TH Ave
Phoenix, AZ 85017-4703

Mailing address

3003 N Central Ave Ste 400
Phoenix, AZ 85012-2929
Phone (602) 685-6000

Other names 1

  • Robert Dick Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20240114000119 AZ Practitioner - Mental Health Counselor 6204288335 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LPC-22252AZMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Terros Inc CurrentSince Jan 1, 2024 Accepting new patients
Terros, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Terros, Inc. Current Accepting new patients

Locations

4909 E McDowell Rd
Phoenix, AZ 85008
Phone (602) 244-9591

3864 N 27th Ave
Phoenix, AZ 85017
Phone (602) 358-0078

3003 N Central Ave
Ste 400
Phoenix, AZ 85012
Phone (602) 351-3015

3385 N Campbell Ave
Tucson, AZ 85719
Phone (520) 320-0800

Interoperability endpoints

  • Direct secure messaging: robert.goldendick.p1@direct.terros.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1688342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1295412153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 N CENTRAL AVE STE 400",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122929",
            "telephone_number": "602-685-6000",
            "fax_number": "602-302-7925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3864 N 27TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850174703",
            "telephone_number": "602-685-6000",
            "fax_number": "602-212-6250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDEN-DICK",
        "first_name": "ROBERT",
        "credential": "MA, NCC, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-03",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LPC-22252",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-22252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBERT",
            "last_name": "DICK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.