Joseph Lee Dickerson Jr., M. ED

Primary specialty

CounselorTaxonomy code 101Y00000X

License

C022013000914 Issued in CT

Practice address

872 Vernon St
Manchester, CT 06042-2415

Phone

(860) 882-9117

NPI assigned

Apr 30, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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, 1999

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

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.

• Dickerson Enterprise LLC

  dba Dickerson Counseling and Therapy Center

  • Community/Behavioral Health Agency
  • Manchester, CT
  • NPI 1669993663
  Medicare reassignment NPD Authorized official
• Dickerson Enterprise LLC

  dba Dickerson Counseling & Therapy Center

  • Professional Counselor
  • Manchester, CT
  • NPI 1831534213
  NPD Authorized official

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

{
    "created_epoch": "1367280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367280000000",
    "number": "1780029165",
    "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": "860-882-9117"
        },
        {
            "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": "860-882-9117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "JOSEPH",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "M. ED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-30",
        "last_updated": "2013-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CT",
            "license": "C022013000914",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "C022013000914",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Diaz
• Sandy N Diaz
• Dickerson Enterprise LLC (Dickerson Counseling and Therapy Center)
• Dickerson Enterprise LLC (Dickerson Counseling & Therapy Center)
• Ethel Dickerson, LCSW
• Digestive Health Specialists of Eastern Connecticut LLC
• Jacob M Diiorio
• Scott Maurice Dillard, D.D.S.
• Sydney J Dillon
• Jeannie Dilworth, APRN

• Counselor in Manchester, CT
• Providers in Manchester, CT by specialty
• Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2013; 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.