Pamela Dickerson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

255410 Issued in KY

Practice address

7459 Burlington Pike
Florence, KY 41042-1553

Phone

(859) 331-3292

Fax

(859) 578-2864

NPI assigned

Sep 9, 2015

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Counseling and Diagnostic Center LLCGroup PAC ID 4981976222, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Counseling and Diagnostic Center, LLC

  dba Counseling & Diagnostic Centers

  • Clinical Psychologist
  • Florence, KY
  • NPI 1679644967
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1441756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1558739490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 FARRELL DR",
            "city": "COVINGTON",
            "state": "KY",
            "postal_code": "410113717",
            "telephone_number": "859-578-3204",
            "fax_number": "859-578-3273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7459 BURLINGTON PIKE",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410421553",
            "telephone_number": "859-331-3292",
            "fax_number": "859-578-2864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "PAMELA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-09",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "255410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "610661458",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dental Sleep Medicine of Northern Kentucky, PLLC
• Dental Sleep Therapy of Greater Cincinnati PSC
• Dermatology Associates of Northern Kentucky PSC
• Barbara Jean Derosa, ARNP
• Bella Grace Derrough
• Didio Chiropractic Center
• Brittany M Diehl, RD
• Julia Marie Diener, PA-C
• Lindsay A Dillon, PA
• Anna Dilonardo, DPT

• Clinical Social Worker in Florence, KY
• Providers in Florence, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.