NPIMap

Organization Active NPI

Dickerson Enterprise LLC

Doing business as Dickerson Counseling & Therapy Center

  • Professional Counselor
  • Manchester, CT
National Provider Identifier
1831534213
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3221 Issued in CT
Legal business name
DICKERSON ENTERPRISE LLC
Doing business as
Dickerson Counseling & Therapy Center
Practice address
872 Vernon St
Manchester, CT 06042-2415
Phone
(860) 416-3500
NPI assigned
Apr 30, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Joseph Lee Dickerson Jr., LPCNPI 1780029165
Title
Ceo
Phone
(860) 416-3500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 3221 CT Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

872 Vernon St
Manchester, CT 06042-2415

Mailing address

872 Vernon St
Manchester, CT 06042-2415
Phone (860) 416-3500

Other names 1

  • Dickerson Counseling & Therapy Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dickerson Counseling and Therapy Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1367280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1831534213",
    "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": "860-416-3500"
        },
        {
            "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": "860-416-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DICKERSON ENTERPRISE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-30",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "DICKERSON",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "860-416-3500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "3221",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dickerson Counseling & Therapy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manchester, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.