Active NPI
Erin M Dickerson, LCSW
- Clinical Social Worker
- Fishers, IN
National Provider Identifier
1427123744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34003984A
- Practice address
- 11075 Village Square LN
Fishers, IN 46038-4552 - Phone
- (317) 598-9997
- NPI assigned
- Nov 21, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 34003984A | IN | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | C874 | IN |
Addresses
Primary practice location
11075 Village Square LN
Fishers, IN 46038-4552
Mailing address
11075 Village Square LN
Fishers, IN 46038-4552
Phone (317) 598-9997
Other names 1
- Erin M Kleindorfer
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C874 | IN | MD | Addiction (Substance Use Disorder) Counselor |
| 34003984A | IN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dawn Crossman Inc | Clinical | Past | Accepting new patients |
| Confidential Care, LTD. | Clinical | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Clinical Social Worker
- Fishers, IN
- NPI 1427237171
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224201600000",
"number": "1427123744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11075 VILLAGE SQUARE LN",
"city": "FISHERS",
"state": "IN",
"postal_code": "460384552",
"telephone_number": "317-598-9997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11075 VILLAGE SQUARE LN",
"city": "FISHERS",
"state": "IN",
"postal_code": "460384552",
"telephone_number": "317-598-9997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKERSON",
"first_name": "ERIN",
"middle_name": "M",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-21",
"last_updated": "2008-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34003984A",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "IN",
"license": "C874",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ERIN",
"last_name": "KLEINDORFER",
"middle_name": "M",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Fishers, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.