KIMBERLY DICK (NPI# 1346804390) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346804390 |
| Entity Type | Individual |
| Full Name | KIMBERLY DICK |
| Credential | MA, BCBA |
| Practice Address |
4422 E State Blvd Fort Wayne IN 46815-6917 |
| Mailing Address |
3500 Depauw Blvd Ste 3070 Indianapolis IN 46268-6135 |
| Practice Telephone | 2604719263 |
| Practice Fax Number | 3175208200 |
| Mailing Telephone | 8553240885 |
| Mailing Fax Number | 3175208200 |
| Enumeration Date | 2019-04-25 |
| Last Update Date | 2019-04-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
4422 E STATE BLVD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46815-6917 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093074759 | Anne Schultz Metzger | Behavioral Analyst | 4422 E State Blvd, Fort Wayne, IN 46815-6917 | 2012-05-15 |
| 1194322263 | Courtney Elizabeth Selvia | Behavior Technician | 4422 E State Blvd, Fort Wayne, IN 46815-6917 | 2020-10-02 |
| 1144827163 | Megan Leigh Torrijos | Behavior Technician | 4422 E State Blvd, Fort Wayne, IN 46815-6917 | 2020-10-02 |
| 1205433224 | Deborah Baker Graham | Behavior Technician | 4422 E State Blvd, Fort Wayne, IN 46815-6917 | 2020-10-02 |
| 1275130353 | Brittany Nicole Bowers | Behavior Technician | 4422 E State Blvd, Fort Wayne, IN 46815-6917 | 2020-10-02 |
| 1134726367 | Grace Esther Barge | Behavior Technician | 4422 E State Blvd, Fort Wayne, IN 46815-6917 | 2020-10-01 |
| 1881291011 | Ryan Michael Blair | Behavior Technician | 4422 E State Blvd, Fort Wayne, IN 46815-6917 | 2020-10-01 |
| 1396352670 | Jacie Nicole Hartman | Behavior Technician | 4422 E State Blvd, Fort Wayne, IN 46815-6917 | 2020-09-30 |
| 1336756642 | Shardae Annt'e Wilson | Behavior Technician | 4422 E State Blvd, Fort Wayne, IN 46815-6917 | 2020-09-30 |
| 1649887951 | Caitlin Marie Ireland | Behavior Technician | 4422 E State Blvd, Fort Wayne, IN 46815-6917 | 2020-09-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306305438 | Sullivan Services, Inc. | In Home Supportive Care | 2789-b Maplecrest Rd, Fort Wayne, IN 46815 | 2019-03-18 |
| 1598250144 | Altermease Gleason | Massage Therapist | 3406 Thames Drive, Fort Wayne, IN 46815 | 2018-06-26 |
| 1881000222 | Denise Sparks | Specialist | 6415 Benham Drive, Fort Wayne, IN 46815 | 2014-07-07 |
| 1962823138 | Chad Distelrath | Physical Therapy Assistant | 1717 Maplecrest Rd, Apt 112, Fort Wayne, IN 46815 | 2013-12-13 |
| 1689943409 | Kendall Joan Labrash | Physical Therapist | 4251 Lahmeyer Rd., Fort Wayne, IN 46815 | 2011-12-22 |
| 1801179718 | Jayson Laube | Pharmacist | 6201 Stellhorn, Fort Wayne, IN 46815 | 2011-09-27 |
| 1720294432 | Muscle Therapy Clinic LLC | Massage Therapist | 6409 Georgetown North Blvd, Fort Wayne, IN 46815 | 2007-05-16 |
| 1427186436 | Legoras Conture Fashions | Prosthetic/Orthotic Supplier | 3316 Inwood Drive, Fort Wayne, IN 46815 | 2007-03-01 |
| 1932252772 | Fort Wayne Smiles PC | Dentist | 2031 Reed Road, Fort Wayne, IN 46815 | 2007-01-18 |
| 1811078538 | Timothy Doody Lynch | Dentist | 4207 Hobson Court, Fort Wayne, IN 46815 | 2006-10-18 |
| Find all providers in zip 46815 | ||||
| Taxonomy Code | 103TA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982884136 | Ann Louise Cangemi | Psychologist | 10123 Red Oak Ct, Fort Wayne, IN 46804-5223 | 2007-11-05 |
| 1306897004 | Park Center Inc | Psychologist | 909 E State Blvd, Fort Wayne, IN 46805-3404 | 2006-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174121172 | Tyrone B Barnes | Psychologist | 3805 N Wittfield St, Indianapolis, IN 46235-2123 | 2020-10-12 |
| 1447874300 | Catherine A Welsh | Psychologist | 12732 Fuller Ct, Fishers, IN 46038-1084 | 2020-06-05 |
| 1184260010 | James R Hurst Phd LLC | Psychologist | 6910 N Main St Unit 12, Granger, IN 46530-9681 | 2019-11-26 |
| 1376827915 | Boyd Randal Horton | Psychologist | 1800 N Meridian St Ste 202, Indianapolis, IN 46202-1443 | 2011-09-30 |
| 1316244627 | Michael Anthony Johnson | Psychologist | 6208 N College Ave, Indianapolis, IN 46220-1927 | 2011-02-22 |
| 1194880088 | Thomas James Johnson | Psychologist | Indiana State University Department of Psychology, 450 North 7th Street, Terre Haute, IN 47809-0001 | 2006-12-22 |
| 1144202292 | Antonio Carrelli | Psychologist | 927 N Pennsylvania St, Indianapolis, IN 46204-1020 | 2005-11-15 |
| 1669931341 | Amanda Adhami | Psychologist | 645 N Walnut St, Bloomington, IN 47404-3846 | 2019-03-13 |
| 1760922249 | The Health and Hospital Corporation of Marion County | Psychologist | 832 N Meridian St, Indianapolis, IN 46204-1108 | 2017-03-02 |
| 1467667733 | Andrew R. Guljas | Psychologist | 4218 W Western Ave, South Bend, IN 46619-2617 | 2007-05-11 |
| Find all providers with the same taxonomy | ||||
| City | FORT WAYNE |
| Zip Code | 46815 |
Please comment or provide details below to improve the information on KIMBERLY DICK.
| 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.