G Teal Dick, M.DIV. LPC-S

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

1489 Issued in AL

Practice address

1881 County Road 627
Thorsby, AL 35171-8151

Phone

(205) 389-2079

NPI assigned

May 6, 2008

Last updated

Oct 27, 2014By the provider in NPPES

Sex

Male

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

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Still Waters Counseling and Education CenterGroup PAC ID 3476087362, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Still Waters Counseling and Education Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mountain BRK, AL
  • NPI 1134954654
  Medicare reassignment Care Compare group NPD
• Alabama Family Resource Center, PC

  • Professional Counselor
  • Thorsby, AL
  • NPI 1639575426
  NPD (past) Authorized official

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

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414368000000",
    "number": "1730355017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 55",
            "city": "THORSBY",
            "state": "AL",
            "postal_code": "351713428",
            "telephone_number": "205-389-2079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 COUNTY ROAD 627",
            "city": "THORSBY",
            "state": "AL",
            "postal_code": "351718151",
            "telephone_number": "205-389-2079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICK",
        "first_name": "G",
        "middle_name": "TEAL",
        "credential": "M.DIV. LPC-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-06",
        "last_updated": "2014-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AL",
            "license": "1489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Clare Broussard, MS, RDN
• Josephine Brown, FNP
• Cenrtal Alabama Medical Associates (Northside Family Practice Clinic)
• Chilton Family Medicine, P.C.
• Clanton Hospital LLC (Northside Family Practice Clinic)
• Claud Griffin Hornsby, D.M.D.
• Keela Ray, PT, DPT
• Southeastern Med Consultants, LLC.
• Thorsby Dental Clinic
• Thorsby Dental LLC (Thorssby Dental Clinic)

• Professional Counselor in Thorsby, AL
• Providers in Thorsby, AL by specialty
• Professional Counselor in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.