Sue Dickerson, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

17935 Issued in TX

Practice address

1052 E Washington St
Stephenville, TX 76401-4558

Phone

(254) 965-3611

Fax

(254) 965-3618

NPI assigned

Apr 6, 2009

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Countryside Therapy Group, Inc

  • Rehabilitation Clinic/Center
  • Stephenville, TX
  • NPI 1710999289

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1238976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238976000000",
    "number": "1801038880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1052 E WASHINGTON ST",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764014558",
            "telephone_number": "254-965-3611",
            "fax_number": "254-965-3618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1052 E WASHINGTON ST",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764014558",
            "telephone_number": "254-965-3611",
            "fax_number": "254-965-3618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-06",
        "last_updated": "2009-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "17935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Baili Deaver, COTA
• Dawn Degreve, CCC-SLP
• Alyssa Nicole Dejong, PA-C
• Shawnte Larae Deyon, SLP
• Stephanie Diaz, PT
• Alliyah Dillard
• Paul Dillard
• Tina Dipprey, SLP
• Kelly Smith Doggett, M.D.
• Angela Sue Donley, CNP

• Speech-Language Pathologist in Stephenville, TX
• Providers in Stephenville, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2009; 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.