Janell K Dickson, LPC

Individual provider Active NPI Mental Health Counselor · Dilkon, AZ

NPI 1538697396 · NPPES record last updated Jul 2, 2019

Key facts

NPI
1538697396
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
16517 (AZ)
Practice address
1/4 Mile NE of Bashas
Dilkon, AZ 86047
Phone
(928) 657-8000
Fax
(928) 657-8009
NPI assigned
May 24, 2017
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
16517AZMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dilkon Outpatient Treatment Center Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 16517 AZ Yes

Addresses

Primary practice location

1/4 Mile NE of Bashas
Dilkon, AZ 86047

Mailing address

PO Box 7072
Winslow, AZ 86047-7072
Phone (928) 657-8000

Other providers in Dilkon, AZ

All providers in Dilkon, AZ · Mental Health Counselor in Arizona

Sources for this page

Verify at the official NPI Registry.