Gwendolyn Dickson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

042222 Issued in NY

Practice address

796H Drew St
Brooklyn, NY 11208-4704

Phone

(718) 235-3100

Fax

(718) 277-0822

NPI assigned

Mar 6, 2008

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)

Enrolled

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 and National Provider Directory roles.

• Coordinated Behavioral Care Ipa Inc

  • Multi-Specialty Clinic/Center
  • Bronx, NY
  • NPI 1457881443
  NPD (past)
• New York Psychotherapy and Counseling Center

  • Community/Behavioral Health Agency
  • Jamaica, NY
  • NPI 1902811342
  NPD (past)

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

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204761600000",
    "number": "1669642633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18907 PINEVILLE LN",
            "city": "SPRINGFIELD GARDENS",
            "state": "NY",
            "postal_code": "114131534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "796H DREW ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112084704",
            "telephone_number": "718-235-3100",
            "fax_number": "718-277-0822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKSON",
        "first_name": "GWENDOLYN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-06",
        "last_updated": "2008-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "042222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nitasha Rae Dickes, BCBA, PLMHP
• Eitan Dickman, M.D.
• Grace Dickman, LMSW, LCSW
• Ian Vebert Malvar Dickman
• John Andrew Dickman, LMSW
• Idongesit Dickson, OTR/L
• Leslie Augustus Dickson, LPN
• Ruth Dickson
• Shanda Dickson, RN
• Darcey Dicostanzo, LCSW

• Clinical Social Worker in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; 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.