Judith Coates Dickens, MPA MS LPC LCAS CCS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6867 Issued in NC

Practice address

111 Windel Dr Ste 205
Raleigh, NC 27609-4477

Phone

(919) 610-5172

Fax

(919) 896-7957

NPI assigned

Sep 13, 2007

Last updated

May 3, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1189641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367539200000",
    "number": "1811182793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5405 FIELDSTONE DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094713",
            "telephone_number": "919-610-5172",
            "fax_number": "919-896-7957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 WINDEL DR STE 205",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094477",
            "telephone_number": "919-610-5172",
            "fax_number": "919-896-7957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKENS",
        "first_name": "JUDITH",
        "middle_name": "COATES",
        "name_prefix": "Mrs.",
        "credential": "MPA MS LPC LCAS CCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-13",
        "last_updated": "2013-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "392",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "1137",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "6867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6111980",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Marcus Dick II, PHD, CGP, AC
• Burke Dickens, NP
• Danysha Moore Dickens, LCSWA
• Erin Cobbler Dickens, AUD
• Gabriel Matthew Dickens, DC
• Keeshana C Dickens, LCSW-A, LCAS-A
• Keya Dickens
• Mahlon Alan Dickens, MD
• Steven Dickens, D.D.S., M.S.
• Courtney R Dickerson

• Professional Counselor in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2013; 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.