Individual provider Active NPI

Veronica Dickens, MA, LMFT

  • Marriage & Family Therapist
  • Windermere, FL
National Provider Identifier
1922465228
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT4913 Issued in FL
Practice address
9100 Conroy Rd.
Windermere, FL 34786
Phone
(321) 340-1181
NPI assigned
Jan 19, 2016
Last updated
Jun 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MT4913 FL Primary
Marriage & Family Therapist 106H00000X PMT225 FL

Addresses

Primary practice location

9100 Conroy Rd.
Windermere, FL 34786

Mailing address

4821 Sanoma VLG
Orlando, FL 32808-1231
Phone (407) 879-7028

Other practice location 1

5401 S Kirkman Rd Ste 338
Orlando, FL 32819-7940
Phone (321) 340-1181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240715001355 FL Practitioner - Marriage and Family Therapist 3375088354 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emotional Intelligence Counseling and Testing LLCGroup PAC ID 3274981865, 2 clinicians

Practice addresses (Care Compare)

9100 Conroy Windermere Rd
Suite 200
Windermere, FL 34786-8431
Phone (407) 928-4233

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
PMT225FLMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Living Life LLC Marriage & Family Therapist CurrentSince Jan 12, 2022 Accepting new patients
Emotional Intelligence Counseling and Testing LLC CurrentSince Jun 3, 2024 Accepting new patients

Locations

5401 S Kirkman Rd
#338
Orlando, FL 32819
Phone (321) 340-1181

5401 S Kirkman Rd
Ste 338
Orlando, FL 32819
Phone (321) 340-1181

9100 Conroy Windermere Rd
Ste 200
Windermere, FL 34786
Phone (407) 395-2042

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

NPI Registry JSON

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

{
    "created_epoch": "1453161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1922465228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4821 SANOMA VLG",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328081231",
            "telephone_number": "407-879-7028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 CONROY RD.",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "34786",
            "telephone_number": "321-340-1181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5401 S Kirkman Rd Ste 338",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328197940",
            "country_code": "US",
            "telephone_number": "321-340-1181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKENS",
        "first_name": "VERONICA",
        "name_prefix": "Mrs.",
        "credential": "MA, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-19",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT4913",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "PMT225",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windermere, FL

Sources for this page

Verify at the official NPI Registry.