Kelly A Dickinson, PH. D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY3728 Issued in WA

Practice address

522 W Riverside Ave # 6728
Spokane, WA 99201-0580

Phone

(253) 553-3483

NPI assigned

Jul 5, 2006

Last updated

Apr 26, 2025By the provider in NPPES

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

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.

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pathwise Psychology PLLC

  • Clinical Psychologist
  • Spokane, WA
  • NPI 1922805647
  NPD Authorized official

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745625600000",
    "number": "1841221207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32020 32ND AVE S STE 110",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980019349",
            "telephone_number": "253-838-3090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 W RIVERSIDE AVE # 6728",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992010580",
            "telephone_number": "253-553-3483"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "32020 32nd Ave S",
            "address_purpose": "LOCATION",
            "city": "Federal Way",
            "state": "WA",
            "postal_code": "980019349",
            "country_code": "US",
            "telephone_number": "253-838-3090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKINSON",
        "first_name": "KELLY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PH. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2025-04-26",
        "certification_date": "2025-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY3728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Grace Dickens, CBT
• Taylor Lee Dickerson
• Katie Dickeson, RN
• Heidi Carrian Dickinson, RN
• Katharine V Dickinson, MSW
• Arianna Nicole Dickman
• Heather Marie Dickson
• Mark E Didier, MD
• Nathan Diehl
• Grace Diemoz

• Clinical Psychologist in Spokane, WA
• Providers in Spokane, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.