Ada Dickinson, MA LMHC ATR BC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

39000397A Issued in IN

Practice address

3010 E State Blvd
Fort Wayne, IN 46805

Phone

(260) 471-2300

Fax

(260) 471-2778

NPI assigned

Sep 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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.

• Center for Neurobehavioral Services Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Wayne, IN
  • NPI 1548275258
  NPD (past)

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932201126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46805",
            "telephone_number": "260-471-2300",
            "fax_number": "260-471-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46805",
            "telephone_number": "260-471-2300",
            "fax_number": "260-471-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKINSON",
        "first_name": "ADA",
        "name_prefix": "Ms.",
        "credential": "MA LMHC ATR BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39000397A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000248937",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "294323",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lori Kaye Dick, CNA
• Michael Philip Dick, M.D.
• Caiden Dicke
• Timothy Dickens
• Anna Dickerson
• Julia Rose Dickman, PHARMD
• Alisha Michelle Dickmeyer, PA-C
• Mark C. Dickmeyer, MD
• Briana Dickson
• Lauren Marie Didier, PA-C

• Mental Health Counselor in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.