3 Dimension Inc

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

36829 Issued in TX

Legal business name

3 DIMENSION INC

Practice address

910 Jamie Dr
Grand Prairie, TX 75052-2735

Phone

(800) 254-0710

Fax

(800) 254-7175

NPI assigned

Dec 11, 2014

Last updated

Dec 11, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Donna S Nickerson, LCSWNPI 1215349311

Title

Owner

Phone

(800) 254-0710

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Donna Shemanne Nickerson, LCSW

  • Clinical Social Worker
  • Burleson, TX
  • NPI 1215349311
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1418256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418256000000",
    "number": "1942608658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 JAMIE DR",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750522735",
            "telephone_number": "800-254-0710",
            "fax_number": "800-254-7175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 JAMIE DR",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750522735",
            "telephone_number": "800-254-0710",
            "fax_number": "800-254-7175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "3 DIMENSION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-11",
        "last_updated": "2014-12-11",
        "status": "A",
        "authorized_official_last_name": "NICKERSON",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "800-254-0710",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "36829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.