Kristen Noel Dickens, PH.D., LPC, ACS, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

011544 Issued in GA

Practice address

326 Myrtle Crossing Dr Ste 200
Statesboro, GA 30458-4689

Phone

(912) 489-7590

NPI assigned

Aug 15, 2020

Sex

Female

Sole proprietor

Yes

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

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fresh Start Counseling Services

  • Professional Counselor
  • Statesboro, GA
  • NPI 1093029019
  NPD (past)

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

{
    "created_epoch": "1597449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597449600000",
    "number": "1568073203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 DRIFTWOOD CT",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580279",
            "telephone_number": "704-277-2806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 MYRTLE CROSSING DR STE 200",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304584689",
            "telephone_number": "912-489-7590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKENS",
        "first_name": "KRISTEN",
        "middle_name": "NOEL",
        "name_prefix": "Dr.",
        "credential": "PH.D., LPC, ACS, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-15",
        "last_updated": "2020-08-15",
        "certification_date": "2020-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "011544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bralie Dent
• David Derosso, CRNA
• Nancy W. Derr, RN, IBCLC
• Donald Devine, LMT
• Susmita Dey, MPH
• Nicolle Maria Digerolamo-Thaller, APRN, BC
• Colin A. Dodds, M.D
• Janine M Dodds, MD
• Dogwood Pediatric Dentistry of Statesboro, LLC (Dogwood Pediatric Dentistry of Statesboro)
• Gayla Donaldson

• Professional Counselor in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2020; 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.