Basic Information
| Provider Information | |||||||||
| NPI: | 1225189046 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DEBBIE E. DICKSON COUNSELING, INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | OHIO PSYCHIATRIC ASSOCIATION | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 41191 TR 78 | ||||||||
| Address2: | |||||||||
| City: | COSHOCTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 43812 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7402949006 | ||||||||
| FaxNumber: | 7405872822 | ||||||||
| Practice Location | |||||||||
| Address1: | 41191 TR 78 | ||||||||
| Address2: | |||||||||
| City: | COSHOCTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 43812 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7402949006 | ||||||||
| FaxNumber: | 7405872822 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/16/2007 | ||||||||
| LastUpdateDate: | 11/11/2010 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | DICKSON | ||||||||
| AuthorizedOfficialFirstName: | DEBBIE | ||||||||
| AuthorizedOfficialMiddleName: | ELAINE | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7402949006 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | LISW | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | I0005776 | OH | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health |
ID Information
| ID | Type | State | Issuer | Description | 1982718128 | 01 | OH | NPI | OTHER |