Individual provider Active NPI

William Dickey III, LPCC

  • Professional Counselor
  • Warren, OH
National Provider Identifier
1811455256
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.2404367 Issued in OH
Practice address
1716 North Rd SE
Warren, OH 44484-2907
Phone
(330) 539-3200
NPI assigned
Mar 5, 2019
Last updated
Nov 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Professional Counselor 101YP2500X E.2404367 OH Primary

Addresses

Primary practice location

1716 North Rd SE
Warren, OH 44484-2907

Mailing address

7051 West Blvd Apt 18
Youngstown, OH 44512-4305

Other practice location 1

40722 State Route 154
Lisbon, OH 44432-8500
Phone (330) 506-1910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20240722002833 OH Practitioner - Mental Health Counselor 1254877657 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1716 N Rd SE
Warren, OH 44484-2907
Phone (330) 539-3200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Professional CurrentSince Nov 6, 2024 Accepting new patients
Open Water Counseling and Recovery, LLC CurrentSince Jun 14, 2024 Accepting new patients
Open Water Counseling and Recovery, LLC CurrentSince Jun 14, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

4449 Easton Way
Fl 2
Columbus, OH 43219
Phone (614) 565-8197

1716 North Rd SE
Warren, OH 44484
Phone (330) 399-9776

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/openwatercounseling/r4/

Organizations & group practices 3

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": "1551744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1811455256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7051 WEST BLVD APT 18",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445124305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 NORTH RD SE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444842907",
            "telephone_number": "330-539-3200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40722 State Route 154",
            "address_purpose": "LOCATION",
            "city": "Lisbon",
            "state": "OH",
            "postal_code": "444328500",
            "country_code": "US",
            "telephone_number": "330-506-1910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKEY",
        "first_name": "WILLIAM",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-05",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.2404367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

Verify at the official NPI Registry.