Michelle Dickerson

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

10513 Judicial Dr Ste 301
Fairfax, VA 22030-7528

Phone

(703) 966-5173

NPI assigned

Jan 30, 2023

Last updated

Jan 30, 2023By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1407562788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10895 POYNTELL CIR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921313312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10513 JUDICIAL DR STE 301",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220307528",
            "telephone_number": "703-966-5173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yesenia Diaz
• Kourosh Dibadj, M.D.
• Samantha Leigh Dibenedetto, MD
• Barry S Dicicco, M.D.
• Ian Edwin Dick, PA-C
• Ryan Dickerson
• Kristen Dickert, FNP
• Nana Dickson, D.D.S.
• Nicole Alyssa Emma Dietz, MD, PHD
• Marie Bernadette Gaston Diez, F.N.P.

• Professional Counselor in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.