JEREMY W DICKSON (NPI# 1295113694) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295113694 |
| Entity Type | Individual |
| Full Name | JEREMY W DICKSON |
| Credential | MA, LPC |
| Practice Address |
323 E Grand St Springfield MO 65807 |
| Mailing Address |
1300 E Bradford Pkwy Springfield MO 65804-4264 |
| Practice Telephone | 4177615600 |
| Practice Fax Number | 4177615601 |
| Mailing Telephone | 4177615000 |
| Mailing Fax Number | 4177615011 |
| Enumeration Date | 2015-05-18 |
| Last Update Date | 2020-09-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | 2015014046 | MO | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 490021929 | 05 |
| Street Address |
323 E GRAND ST |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65807 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144202912 | Erika L Crabtree | Counselor | 323 E Grand St, Springfield, MO 65807-1447 | 2005-11-17 |
| 1104427624 | Lee Owen Cunningham | Pharmacist | 323 E Grand St, Springfield, MO 65807-1447 | 2020-11-02 |
| 1922513894 | Micah A Gillen | Counselor | 323 E Grand St, Springfield, MO 65807-1447 | 2017-12-13 |
| 1548612468 | Tedra E Estis | Nurse Practitioner | 323 E Grand St, Springfield, MO 65807-1447 | 2016-07-02 |
| 1194190066 | Burrell, Inc. | Pharmacy | 323 E Grand St, Springfield, MO 65807-1447 | 2015-12-03 |
| 1396144051 | Tanya Rea Johnson | Counselor | 323 E Grand St, Springfield, MO 65807-1447 | 2014-08-19 |
| 1730475666 | Susan Michelle Baker | Counselor | 323 E Grand St, Springfield, MO 65807-1447 | 2011-06-20 |
| 1942523493 | Cristin R Martinez | Counselor | 323 E Grand St, Springfield, MO 65807-1447 | 2010-03-11 |
| 1093848913 | Advocates for A Healthy Community, Inc | Clinic/Center | 323 E Grand St, Springfield, MO 65807-1447 | 2007-03-13 |
| 1588773477 | Advocates for A Healthy Community, Inc. | Clinic/Center | 323 E Grand St, Springfield, MO 65807-1447 | 2006-08-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396390241 | Karley Kassandra Murphy | Counselor | 3734 South Ave #c, Springfield, MO 65807 | 2019-08-07 |
| 1396203626 | Auvia L Logan | Dietitian, Registered | 3322 S. Campbell Ave. Suite Cc, Springfield, MO 65807 | 2019-03-05 |
| 1598250961 | Kathryn Barber | Nurse Practitioner | 3800 S National Ave Ste 700, Springfield, MO 65807 | 2018-06-27 |
| 1447764899 | Missouri Midwifery Service | Clinic/Center | 3840 South Avenue, Springfield, MO 65807 | 2017-11-21 |
| 1124530290 | Senior Living Management Group, LLC | Skilled Nursing Facility | 3705 S Jefferson Ave, Springfield, MO 65807 | 2017-10-30 |
| 1740663335 | Sarah E Kirk | Physical Therapist | 3545 S. National Ave, Springfield, MO 65807 | 2015-07-01 |
| 1750713335 | Amanda Ward | Nurse Practitioner | 2150 W Republic Rd Ste 112, Springfield, MO 65807 | 2013-08-06 |
| 1932531126 | Eugenia R Cortez | Counselor | 2124 Chesterfield Blvd., Springfield, MO 65807 | 2013-07-30 |
| 1962742866 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3045 W Republic St, Springfield, MO 65807 | 2013-03-01 |
| 1033462387 | Miguel Angel Medina | Physician Assistant | 1900 South Sunshine Ave., Springfield, MO 65807 | 2012-10-24 |
| Find all providers in zip 65807 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427672815 | Jana Lynn Purington | Counselor | 155 Maple St Ste 107, Springfield, MA 01105-1828 | 2020-06-02 |
| 1861015224 | Laurie N Tackett | Counselor | 255 Glenmore Dr, Springfield, OH 45503-3305 | 2020-05-20 |
| 1457993412 | Ardavis & Associates, LLC | Counselor | 2151 W White Oaks Dr Ste D, Springfield, IL 62704-6410 | 2019-10-11 |
| 1396390241 | Karley Kassandra Murphy | Counselor | 3734 South Ave #c, Springfield, MO 65807 | 2019-08-07 |
| 1861057457 | Janer Hernandez | Counselor | 77 Bevier St, Springfield, MA 01107-1316 | 2019-05-08 |
| 1013470608 | Aracelis Ruiz | Counselor | 1108 Carew St, Springfield, MA 01104-2026 | 2019-04-10 |
| 1619432481 | Beth Reilly | Counselor | 57 Duryea St, Springfield, MA 01104-3105 | 2019-02-06 |
| 1023582699 | Barbara Ruth Pascoe | Counselor | 8020 Greeley Blvd, Springfield, VA 22152-3001 | 2019-01-17 |
| 1275000309 | Sara Thompson | Counselor | 2200 E Sunshine St Ste 215, Springfield, MO 65804-1886 | 2018-10-26 |
| 1902305402 | Stan Dwane Buford | Counselor | 3734 South Ave Ste C, Springfield, MO 65807-5291 | 2018-02-09 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65807 |
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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.