Dickerson Enterprise LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

3221 Issued in CT

Legal business name

DICKERSON ENTERPRISE LLC

Practice address

872 Vernon St
Manchester, CT 06042-2415

Phone

(860) 416-3500

NPI assigned

Jun 29, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Joseph Lee DickersonNPI 1780029165

Title

Owner

Phone

(860) 416-3500

Specialties & licenses 1

Addresses

Other names 1

• Dickerson Counseling and Therapy Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Tax ID family

Dickerson Counseling and Therapy Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Dickerson Enterprise LLC

  • Professional Counselor
  • Manchester, CT
  • NPI 1831534213
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joseph Lee Dickerson Jr., M. ED

  • Counselor
  • Manchester, CT
  • NPI 1780029165
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1498694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1669993663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "872 VERNON ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060422415",
            "telephone_number": "860-416-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "872 VERNON ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060422415",
            "telephone_number": "860-416-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "872 Vernon St",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "CT",
            "postal_code": "060422415",
            "country_code": "US",
            "telephone_number": "860-416-3500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DICKERSON ENTERPRISE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-29",
        "last_updated": "2025-09-02",
        "certification_date": "2025-06-20",
        "status": "A",
        "authorized_official_last_name": "DICKERSON",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-416-3500"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CT",
            "license": "3221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dickerson Counseling and Therapy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ariana E Diaz
• Damaris Diaz
• Jenny Diaz
• Joshua Diaz
• Sandy N Diaz
• Dickerson Enterprise LLC
• Ethel Dickerson, LCSW
• Joseph Lee Dickerson Jr., M. ED
• Digestive Health Specialists of Eastern Connecticut LLC
• Jacob M Diiorio

• Community/Behavioral Health Agency in Manchester, CT
• Providers in Manchester, CT by specialty
• Community/Behavioral Health Agency in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.