Michael Keith Dibble Jr., PLLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

62572 Issued in TX

Legal business name

MICHAEL KEITH DIBBLE JR., PLLC

Practice address

4601 Matthew Rd
Grand Prairie, TX 75052-1750

Phone

(469) 278-5901

NPI assigned

May 20, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Michael Keith Dibble Jr., M.A.NPI 1144631508

Title

President

Phone

(214) 632-9242

Specialties & licenses 1

Addresses

Other names 1

• Keith Dibble, LPC Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Keith Dibble Jr., M.A., LPC

  • Professional Counselor
  • Grand Prairie, TX
  • NPI 1144631508
  NPD (past) Authorized official

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

{
    "created_epoch": "1400544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400544000000",
    "number": "1427460864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4322 MATTHEW RD",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750521501",
            "telephone_number": "214-632-9242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 MATTHEW RD",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750521750",
            "telephone_number": "469-278-5901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL KEITH DIBBLE JR., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-20",
        "last_updated": "2014-05-20",
        "status": "A",
        "authorized_official_last_name": "DIBBLE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-632-9242",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.A."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "62572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Keith Dibble, LPC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Professional Counselor in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2014; 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.