Andrea D Dickerson, IADC, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

415 Issued in IA

Practice address

804 Kellogg Ave
Ames, IA 50010-6234

Phone

(515) 233-4930

NPI assigned

Jan 10, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1972652683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 N EISENHOWER AVE",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504017340",
            "telephone_number": "515-233-4930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 KELLOGG AVE",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500106234",
            "telephone_number": "515-233-4930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "804 Kellogg Ave",
            "address_purpose": "LOCATION",
            "city": "Ames",
            "state": "IA",
            "postal_code": "500106234",
            "country_code": "US",
            "telephone_number": "515-233-4930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "ANDREA",
        "middle_name": "D",
        "credential": "IADC, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IA",
            "license": "00112",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IA",
            "license": "415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Ames, IA
• Providers in Ames, IA by specialty
• Marriage & Family Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2019; 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.