NPIMap

Organization Active NPI

Candice Richardson Dickens

  • Mental Health Counselor
  • Catonsville, MD
National Provider Identifier
1861617052
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LC0686 Issued in MD
Legal business name
CANDICE RICHARDSON DICKENS
Doing business as
Cra Counseling & Consulting Agency
Practice address
5602 Baltimore National Pike
307
Catonsville, MD 21228-1411
Phone
(410) 744-4204
Fax
(410) 744-4203
NPI assigned
Apr 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

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

Authorized official

Name
Mrs. Candice Richardson Dickens, LCPC, LCADC, NCCNPI 1578527271
Title
Clinical Director
Phone
(410) 744-4204

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YA0400X LCA214 MD
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X PRC13709 DC
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X LC0686 MD Primary

Addresses

Primary practice location

5602 Baltimore National Pike
307
Catonsville, MD 21228-1411

Mailing address

7859 Paddock Way
Baltimore, MD 21244-1290
Phone (410) 744-4204

Other identifiers 1

IdentifierTypeStateIssuer
6895026 00MedicaidMD

Other names 1

  • Cra Counseling & Consulting Agency Doing business as

National Provider Directory

National Provider Directory

Locations

5602 Baltimore National Pike
Ste 307
Catonsville, MD 21228
Phone (410) 744-4204

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": "1176595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1861617052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7859 PADDOCK WAY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212441290",
            "telephone_number": "410-744-4204",
            "fax_number": "410-744-4203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5602 BALTIMORE NATIONAL PIKE",
            "address_2": "307",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212281411",
            "telephone_number": "410-744-4204",
            "fax_number": "410-744-4203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANDICE RICHARDSON DICKENS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-15",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "DICKENS",
        "authorized_official_first_name": "CANDICE",
        "authorized_official_middle_name": "RICHARDSON",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "410-744-4204",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCPC, LCADC, NCC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "LCA214",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "DC",
            "license": "PRC13709",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC0686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6895026 00",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cra Counseling & Consulting Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Catonsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.