Individual provider Active NPI

Rebecca Dickinson, LMSW

  • Clinical Social Worker
  • Pontiac, MI
National Provider Identifier
1972640811
Registry record updated Jan 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801094691 Issued in MI
Practice address
114 Orchard Lake Rd
Pontiac, MI 48341-2244
Phone
(248) 858-7766
Fax
(248) 858-7201
NPI assigned
Jan 31, 2007
Last updated
Jan 25, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801094691 MI Primary

Addresses

Primary practice location

114 Orchard Lake Rd
Pontiac, MI 48341-2244

Mailing address

114 Orchard Lake Rd
Pontiac, MI 48341-2244
Phone (248) 858-7766

Other identifiers 1

IdentifierTypeStateIssuer
1883825MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20050623000825 MI Practitioner - Clinical Social Worker 0345285938 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

302 S Main St
Suite 202
Royal Oak, MI 48067-2657
Phone (947) 217-3010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801094691MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC CurrentSince Oct 26, 2023 Accepting new patients
Oakland Family Services CurrentSince May 10, 2005 Accepting new patients

Locations

302 S Main St
Ste 202
Royal Oak, MI 48067
Phone (947) 217-2743

7333 Triangle Dr
Sterling Hts, MI 48314
Phone (248) 686-3347

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

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": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327449600000",
    "number": "1972640811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 ORCHARD LAKE RD",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483412244",
            "telephone_number": "248-858-7766",
            "fax_number": "248-858-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 ORCHARD LAKE RD",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483412244",
            "telephone_number": "248-858-7766",
            "fax_number": "248-858-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKINSON",
        "first_name": "REBECCA",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2012-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801094691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1883825",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.