KELLIE JO DICKINSON (NPI# 1861890634) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861890634 |
| Entity Type | Individual |
| Full Name | KELLIE JO DICKINSON |
| Other Name | KELLY JO GRAHAM |
| Practice Address |
702 Sunset Dr Ontario OR 97914-3121 |
| Practice Telephone | 5418899167 |
| Practice Fax Number | 5418897873 |
| Mailing Telephone | 5418899167 |
| Mailing Fax Number | 5418897873 |
| Enumeration Date | 2014-12-10 |
| Last Update Date | 2014-12-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154555688 | Kellie Dare Dickinson | Occupational Therapist | 10001 Hyde Pl, River Ridge, LA 70123-1521 | 2009-05-12 |
| Street Address |
702 SUNSET DR |
| City | ONTARIO |
| State | OR |
| Zip Code | 97914-3121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821056391 | Judith Poirot | Social Worker | 702 Sunset Dr, Ontario, OR 97914-3121 | 2006-05-03 |
| 1235740994 | Kristie Marlene Lyman | Counselor | 702 Sunset Dr, Ontario, OR 97914-3121 | 2020-08-14 |
| 1083225411 | Hannah Layne Radford | Social Worker | 702 Sunset Dr, Ontario, OR 97914-3121 | 2020-08-10 |
| 1902424724 | Nathan Douglas Barraza | Counselor | 702 Sunset Dr, Ontario, OR 97914-3121 | 2020-07-08 |
| 1225656036 | Denys Roy Fuhrmann | Counselor | 702 Sunset Dr, Ontario, OR 97914-3121 | 2020-07-08 |
| 1750907689 | Tamara Kay Ashley | Case Manager/Care Coordinator | 702 Sunset Dr, Ontario, OR 97914-3121 | 2020-06-16 |
| 1104440023 | Leah Dredge | Social Worker | 702 Sunset Dr, Ontario, OR 97914-3121 | 2020-06-05 |
| 1659994176 | Samuel Galan | Counselor | 702 Sunset Dr, Ontario, OR 97914-3121 | 2020-05-19 |
| 1548882434 | James E Burmeister | Case Manager/Care Coordinator | 702 Sunset Dr, Ontario, OR 97914-3121 | 2020-05-13 |
| 1619509247 | Betty Raynor | Counselor | 702 Sunset Dr, Ontario, OR 97914-3121 | 2020-02-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467925420 | The Family Place D/b/a Tfp Services Therapeutic | Case Manager/Care Coordinator | 390 Ne 2nd St., Ontario, OR 97914 | 2019-01-02 |
| 1154805729 | Ronald William Strohmeyer | Physician Assistant | 2327 S.w. 4th Ave, Ontario, OR 97914 | 2018-09-19 |
| 1700334117 | Arlene Schwenke | Social Worker | 686 Nw 9th St., Ontario, OR 97914 | 2016-09-14 |
| 1871990408 | Sally Melissa Sluder | Nurse Practitioner | 351 Sw 9th Ave, Ontario, OR 97914 | 2014-11-25 |
| 1932460870 | E Patricia Jeanne Engel | Surgery | 1050 Sw 3rd Ave Ste 2600, Ontario, OR 97914 | 2012-06-07 |
| 1487946521 | Tyler Jepson | Physical Therapist | 1182 Sw 4th Avenue, Ontario, OR 97914 | 2011-05-09 |
| 1255641577 | Cami Lyn Rebmann | Pharmacist | 728 S 4th Ave, Ontario, OR 97914 | 2010-10-20 |
| 1295051126 | Project Dove | Case Manager/Care Coordinator | 915-02 Sw 2nd Ave, Ontario, OR 97914 | 2010-04-16 |
| 1467666024 | Tfp Therapeutic Service, Inc. | Counselor | 390 Ne 2nd Street, Ontario, OR 97914 | 2007-05-10 |
| 1639381569 | Emeritus Corporation | Assisted Living Facility | 1372 Southwest 8th Avenue, Ontario, OR 97914 | 2007-05-04 |
| Find all providers in zip 97914 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669990768 | Claudia Juarez Tapia | Counselor | 125 W F Street, Ontario, CA 91762 | 2017-09-08 |
| 1417489949 | Kristopher Reyes | Counselor | 125 W F St Unit 101, Ontario, CA 91762-3201 | 2017-04-03 |
| 1326399510 | Kevin V Chandler | Counselor | 1921 E Banyan St, Ontario, CA 91761-6405 | 2012-09-27 |
| 1376772673 | Elizabeth Diane Roberts | Counselor | 747 N. Euclid Ave, Ontario, CA 91762-2878 | 2009-07-08 |
| 1154576650 | Krystle Lasha Greely | Counselor | 1801 Excise Ave Ste 116, Ontario, CA 91761 | 2008-11-25 |
| 1962655456 | Quan L Hancock | Counselor | 125 W F St Ste 101, Ontario, CA 91762-3262 | 2008-10-28 |
| 1144432162 | Rena Cantu | Counselor | 316 East E Street, Ontario, CA 91764 | 2007-05-03 |
| 1184842122 | Rosemary Yates | Counselor | 125 West F St, Ontario, CA 91762 | 2007-04-23 |
| 1457486573 | Gilford C Hoel | Counselor | 30503 Opus Rd, Ontario, WI 54651-6537 | 2007-02-22 |
| 1871636233 | Norman Croom | Counselor | 1647 Holt Blvd, Ontario, CA 91761-2107 | 2007-02-15 |
| Find all providers in ONTARIO | ||||
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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.