Robert A Dickens, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

30285020 Issued in WI

Practice address

4555 W Schroeder Dr
Suite 170
Milwaukee, WI 53223-1475

Phone

(414) 365-3210

Fax

(414) 365-3225

NPI assigned

Dec 5, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

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.

• Blue Waters Family Counseling, S.C.

  • Counselor
  • Manitowoc, WI
  • NPI 1366556359
  NPD (past)

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213228800000",
    "number": "1831173673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 215",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542210125",
            "telephone_number": "920-684-8101",
            "fax_number": "920-684-1224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4555 W SCHROEDER DR",
            "address_2": "SUITE 170",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532231475",
            "telephone_number": "414-365-3210",
            "fax_number": "414-365-3225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKENS",
        "first_name": "ROBERT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2008-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "30285020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31523800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela Helen Dibella, MS-CCC, SLP
• Danielle Dicentio
• Nicholas Dante Dichristofano, MD
• Melissa A Dichristofaro, RN
• Shannon Olivia Dicken, PHARMD
• Shauntun Dickerson
• Anne Dickinson, OTR/L
• Alexis C Dickmann, PA-C
• Elizabeth Louise Dickson Michelson, M. D.
• Michael Anthony Didion, DO

• Psychiatry Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Psychiatry Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2008; 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.