Krista Dickerson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

16498 Issued in SC

Practice address

132 Pine Gate Dr
Summerville, SC 29483-5586

Phone

(843) 252-3116

NPI assigned

Aug 8, 2016

Last updated

May 30, 2025By 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)

Enrolled

State licenses

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

{
    "created_epoch": "1470614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1598219503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 PINE GATE DR",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294835586",
            "telephone_number": "843-252-3116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 PINE GATE DR",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294835586",
            "telephone_number": "843-252-3116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "164 Waccamaw Medical Park Dr",
            "address_purpose": "LOCATION",
            "city": "Conway",
            "state": "SC",
            "postal_code": "295268903",
            "country_code": "US",
            "telephone_number": "843-347-5060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "KRISTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-08",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "16498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn Marie Cameron Devaux, RN, PMHNP-BC
• Brae Dewalt
• Dialysis Clinic Inc (DCI Summerville-Nexton)
• Kristina M Dibartolo, FNP
• Julianne Dicicco-Wiles, MS, CPS, ICPS
• Abigail Dickinson
• Renae Lynn Dietzel
• Dawn Marie Digennaro, LMSW
• Cathie Elizabeth Diggs, LISW-CP
• Chris Digiandomenico, LMSW

• Clinical Social Worker in Summerville, SC
• Providers in Summerville, SC by specialty
• Clinical Social Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2025; 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.