Dennis Michael Dickens, RADT I

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

R1328711118 Issued in CA

Practice address

835 25TH St
San Diego, CA 92102-2738

Phone

(619) 239-9691

Fax

(619) 239-0909

NPI assigned

Dec 27, 2019

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Crash, Inc.

  • Substance Abuse Rehabilitation Facility
  • San Diego, CA
  • NPI 1124539960
  NPD (past)

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

{
    "created_epoch": "1577404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577404800000",
    "number": "1841839545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8851 SANDMARK AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921233915",
            "telephone_number": "619-794-7177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 25TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921022738",
            "telephone_number": "619-239-9691",
            "fax_number": "619-239-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKENS",
        "first_name": "DENNIS",
        "middle_name": "MICHAEL",
        "credential": "RADT I",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-27",
        "last_updated": "2019-12-27",
        "certification_date": "2019-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1328711118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ddickens@crashinc.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "835 25th St",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921022738",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ddickens@crashinc.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "835 25th St",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921022738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• F Victoria Dicicco, PHD
• Joyce N Dicicco, LCSW, CSA
• Melodie Serena Mestas Dick, RN
• Joyce Dickau
• Brionna Dickens
• Rio Dion Dickens, M.D.
• Richard Dicker, PH.D.
• Andrew Burton Dickerson
• Brenna Mae Louise Dickerson
• Catherine Dickerson, L.C.S.W.

• Addiction (Substance Use Disorder) Counselor in San Diego, CA
• Providers in San Diego, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2019; 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.