Individual provider Active NPI

Janet Marie Dickerson, L.P.C.C., R.N.,

  • Professional Counselor
  • Tiffin, OH
National Provider Identifier
1699972349
Registry record updated Sep 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E. 0003629 SUPV Issued in OH
Practice address
24 W Market St
Tiffin, OH 44883-2720
Phone
(419) 448-4094
NPI assigned
Jun 27, 2007
Last updated
Sep 25, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E. 0003629 SUPV OH Primary
Diabetes Educator Registered Nurse 163WD0400X RN. 181935 OH

Addresses

Primary practice location

24 W Market St
Tiffin, OH 44883-2720

Mailing address

149 Clinton Ave
Tiffin, OH 44883-1632
Phone (419) 448-4019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
E. 0003629 SUPVOHMDProfessional Counselor
RN. 181935OHMDDiabetes Educator Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
New Transitions Counseling L.L.C. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190678400000",
    "number": "1699972349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 CLINTON AVE",
            "city": "TIFFIN",
            "state": "OH",
            "postal_code": "448831632",
            "telephone_number": "419-448-4019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 W MARKET ST",
            "city": "TIFFIN",
            "state": "OH",
            "postal_code": "448832720",
            "telephone_number": "419-448-4094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "JANET",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "L.P.C.C., R.N.,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-27",
        "last_updated": "2007-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.  0003629 SUPV",
            "primary": true
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "OH",
            "license": "RN.  181935",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tiffin, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; 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.