JOHN AZAR-DICKENS, PH.D.,PC (NPI# 1093026601) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093026601 |
| Entity Type | Organization |
| Organization Name | JOHN AZAR-DICKENS, PH.D.,PC |
| Practice Address |
109 John Maddox Dr Nw Rome GA 30165-1451 |
| Mailing Address |
Po Box 1008 Rome GA 30162-1008 |
| Practice Telephone | 7062326743 |
| Mailing Telephone | 7062326743 |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2010-06-29 |
| Authorized Official Name | DR. JOHN AZAR-DICKENS (LICENSED PSYCHOLOGIST) |
| Authorized Official Telephone | 7062340659 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
002459 | GA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00895837J | 05 |
| Street Address |
109 JOHN MADDOX DR NW |
| City | ROME |
| State | GA |
| Zip Code | 30165-1451 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447426200 | Gordon Behavioral Sciences P.C. | Psychiatry & Neurology | 109 John Maddox Dr Nw, Rome, GA 30165-1451 | 2008-05-01 |
| 1861883381 | Lauren Sorrow LLC | Community/Behavioral Health | 109 John Maddox Dr Nw, Rome, GA 30165-1451 | 2015-02-06 |
| 1235557158 | Suzanne G. Pratt | Obstetrics & Gynecology | 109 John Maddox Dr Nw, Rome, GA 30165-1451 | 2014-03-29 |
| 1750601308 | Frank Graham Pratt IIi | Social Worker | 109 John Maddox Dr Nw, Rome, GA 30165-1451 | 2010-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346868775 | Heather Bowman | Physical Therapist | 600 Eagle, E Lake Dr, Rome, GA 30165 | 2020-07-13 |
| 1205451101 | Kristopher Nelson | Student in an Organized Health Care Education/Training Program | 4256, 304 Shorter Ave Nw #201, Rome, GA 30165 | 2020-06-16 |
| 1962061457 | Stuart Paul Shaklee | Occupational Therapy Assistant | 1356 Redmond Road, Rome, GA 30165 | 2019-06-10 |
| 1386001055 | Autumn Streetman | Counselor | 6 Mathis Drive, Rome, GA 30165 | 2016-01-26 |
| 1144695784 | Gabrador Milligan | Counselor | 6 Mathis Road, Rome, GA 30165 | 2015-12-08 |
| 1386041952 | Theresa Suits | Registered Nurse | 1 Woodbine Avenue, Rome, GA 30165 | 2014-11-26 |
| 1942561147 | Nicole C. Christian | Clinical Neuropsychologist | 305 Redmond Rd, Rome, GA 30165 | 2012-06-04 |
| 1679832711 | Niki Pareshkumar Bhavsar | Internal Medicine | 3041 Turner Mccall Blvd, Rome, GA 30165 | 2012-05-10 |
| 1285927491 | Amanda Fischer Reeves | Family Medicine | 304 Shorter Ave Nw Ste 102, Rome, GA 30165 | 2011-05-20 |
| 1033436647 | Northland Hearing Centers, Inc. | Hearing Instrument Specialist | 4 Coosawattee Ave, Rome, GA 30165 | 2010-04-23 |
| Find all providers in zip 30165 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760610190 | Gauri Goel | Psychologist | 1608 Anken St, Rome, NY 13440-2304 | 2009-06-24 |
| 1194885475 | Randell Leon Elkins Jr. | Psychologist | 701 Broad St Ste 350, Rome, GA 30161-3092 | 2006-12-09 |
| 1104984103 | John Azar-dickens | Psychologist | 106 E 5th Ave, Rome, GA 30161-3128 | 2006-12-04 |
| 1851460810 | Suzanne Marie Fischer | Psychologist | 104 E 5th Ave, Rome, GA 30161-3128 | 2006-11-06 |
| 1578539565 | Richard D. Hark | Psychologist | 225 Maplecrest Ln Se, Rome, GA 30161-5522 | 2006-02-28 |
| 1700355179 | Lauren Evelyn Reba-harrelson | Psychologist | 1345 Redmond Road, Rome, GA 30165 | 2018-11-15 |
| 1174979975 | Transitions Psychological and Consultative Services, LLC | Psychologist | 104 E 5th Ave, Rome, GA 30161-3128 | 2016-05-11 |
| 1285000976 | Jason Randolph Dunn | Psychologist | 701 Broad St, Ste 350, Rome, GA 30161-3092 | 2015-08-17 |
| 1457658437 | Carolyn Trish Jackson | Psychologist | 125 Brookley Rd, Rome, NY 13441-4301 | 2011-02-28 |
| 1851605083 | Candice Nicole Claiborne | Psychologist | 701 Broad St Ste 350, Rome, GA 30161-3092 | 2010-07-29 |
| Find all providers in ROME | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.