Individual provider Active NPI

Jacob Dickey, TLMHC

  • Mental Health Counselor
  • Burlington, IA
National Provider Identifier
1902633373
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2115 Des Moines Ave
Burlington, IA 52601-4444
Phone
(319) 209-2084
Fax
(319) 209-2086
NPI assigned
Sep 18, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IA Primary

Addresses

Primary practice location

2115 Des Moines Ave
Burlington, IA 52601-4444

Mailing address

2115 Des Moines Ave
Burlington, IA 52601-4444
Phone (319) 209-2084

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Group, Inc. Mental Health CurrentSince Sep 23, 2024 Accepting new patients

Locations

2115 Des Moines Ave
Burlington, IA 52601
Phone (319) 209-2084

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1902633373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 DES MOINES AVE",
            "city": "BURLINGTON",
            "state": "IA",
            "postal_code": "526014444",
            "telephone_number": "319-209-2084",
            "fax_number": "319-209-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 DES MOINES AVE",
            "city": "BURLINGTON",
            "state": "IA",
            "postal_code": "526014444",
            "telephone_number": "319-209-2084",
            "fax_number": "319-209-2086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKEY",
        "first_name": "JACOB",
        "credential": "TLMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.