Shawn M Dickinson

Individual provider Active NPI Social Worker · Ottawa, KS

NPI 1912745720 · NPPES record last updated Jul 16, 2024

Key facts

NPI
1912745720
Entity type
Individual (NPI type 1)
Primary specialty
Social Worker 104100000X
License
13765-T (KS)
Practice address
2537 Eisenhower Rd
Ottawa, KS 66067-9482
Phone
(785) 242-3780
Fax
(785) 242-6397
NPI assigned
Jul 16, 2024
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
13765-TKSMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Elizabeth Layton Center, Inc. Current
since Jul 21, 2024
Accepting new patients
Elizabeth Layton Center, Inc. Current
since Jul 21, 2024
Accepting new patients

Locations

2537 Eisenhower Rd
Ottawa, KS 66067
Phone (785) 242-2183

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 13765-T KS Yes

Addresses

Primary practice location

2537 Eisenhower Rd
Ottawa, KS 66067-9482

Mailing address

PO Box 677
Ottawa, KS 66067-0677
Phone (785) 242-3780

Other providers in Ottawa, KS

All providers in Ottawa, KS · Social Worker in Kansas

Sources for this page

Verify at the official NPI Registry.