Mary Elizabeth Ann Dickout, B.A.,CPRP

Primary specialty

CounselorTaxonomy code 101Y00000X

License

171637 Issued in FL

Practice address

3763 Evans Ave
Fort Myers, FL 33901-9302

Phone

(239) 332-6937

Fax

(239) 332-6985

NPI assigned

Jul 15, 2013

Last updated

Aug 1, 2013By 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

Credentials

Bachelor of Arts

State licenses

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

{
    "created_epoch": "1373846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375315200000",
    "number": "1548601990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3763 EVANS AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019302",
            "telephone_number": "239-931-9827",
            "fax_number": "239-332-6985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3763 EVANS AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019302",
            "telephone_number": "239-332-6937",
            "fax_number": "239-332-6985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKOUT",
        "first_name": "MARY ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "B.A.,CPRP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-15",
        "last_updated": "2013-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "FL",
            "license": "171637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Alec James Dierksheide, DPM

• Counselor in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; 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.