Katina Dickson, MA MATC QMHP-A

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

D2005061525 Issued in VA

Practice address

999 Waterside Dr Ste 2525
Norfolk, VA 23510-3316

Phone

(757) 777-3454

NPI assigned

Jun 18, 2020

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1592438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1417573189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 COLUMBIA ST",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237044003",
            "telephone_number": "757-358-1359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 WATERSIDE DR STE 2525",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235103316",
            "telephone_number": "757-777-3454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKSON",
        "first_name": "KATINA",
        "credential": "MA MATC QMHP-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-18",
        "last_updated": "2023-11-27",
        "certification_date": "2020-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "D2005061525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Theranest.com",
            "affiliation": "Y",
            "endpointDescription": "Therapy Notes",
            "affiliationName": "A Chance for Change LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "useOtherDescription": "notes",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "theranest",
            "address_1": "999 Waterside Dr Ste 2525",
            "city": "Norfolk",
            "state": "VA",
            "country_code": "US",
            "postal_code": "235103316",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kayla L Dickerson, PTA
• Patricia Dickerson, RRT
• Vickie Dickerson
• Raymond Dickinson
• Lynne M. Dickman, M.A. CCC-SLP
• Jane L. Die, M.D.
• Jessica Nicole Diego, DO
• Brittany Leigh Diehl, PA
• Melody Diehl, MA
• Tracy Dien, MD

• Addiction (Substance Use Disorder) Counselor in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Addiction (Substance Use Disorder) Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.