Charles Dickerman, LMFT, CADC III, SUDP in Portland, OR - Medicare Marriage & Family Therapist Provider

Charles Dickerman, LMFT, CADC III, SUDP is a medicare enrolled "Marriage & Family Therapist" provider in Portland, Oregon. His current practice location is 19500 Se Stark St, Portland, Oregon. You can reach out to his office (for appointments etc.) via phone at (503) 249-3434.

Charles Dickerman is licensed to practice in Oregon (license number T0866) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1548433261.

Contact Information

	Charles Dickerman, LMFT, CADC III, SUDP
	19500 Se Stark St, Portland, OR 97233-5757
	(503) 249-3434
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Charles Dickerman
Gender	Male
Speciality	Marriage & Family Therapist
Location	19500 Se Stark St, Portland, Oregon
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1548433261
Provider Enumeration Date: 04/03/2008
Last Update Date: 12/27/2023

Medicare PECOS Information:

PECOS PAC ID: 3870939713
Enrollment ID: I20240313003003

Medical Identifiers

Medical identifiers for Charles Dickerman such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1548433261	NPI	-	NPPES
164936	Medicaid	OR

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YA0400X	Counselor - Addiction (substance Use Disorder)	11-06-19 (Oregon)	Secondary
101YA0400X	Counselor - Addiction (substance Use Disorder)	CP60796757 (Washington)	Secondary
106H00000X	Marriage & Family Therapist	T0866 (Oregon)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Charles Dickerman allows following entities to bill medicare on his behalf.

Entity Name	Kaiser Foundation Health Plan Of The Northwest
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1184786527 PECOS PAC ID: 5799688230 Enrollment ID: O20040130000799

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Charles Dickerman is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Charles Dickerman, LMFT, CADC III, SUDP 19500 Se Stark St, Portland, OR 97233-5757 Ph: (503) 249-3434	Charles Dickerman, LMFT, CADC III, SUDP 19500 Se Stark St, Portland, OR 97233-5757 Ph: (503) 249-3434

Reviews and Comments

Marriage & Family Therapist in Portland, OR

Karissa Lynn Catalano, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 2415 Se 43rd Ave, Portland, OR 97206 Phone: 503-238-0705
Jennifer D Samsom, MA Couples Therapy Medicare: Medicare Enrolled Practice Location: 2245 Sw Troy St, Portland, OR 97219 Phone: 503-341-6393
Therese Long, Couples Therapy Medicare: Medicare Enrolled Practice Location: 4300 Ne Fremont St Ste 260, Portland, OR 97213 Phone: 503-544-9996
Kathia Rabelo, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 820 Nw 21st Ave Ste B, Portland, OR 97209 Phone: 626-318-9783
Jennifer Servin-zuniga, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 4445 S Barbur Blvd Ste 205, Portland, OR 97239 Phone: 503-768-6325
Polly Elizabeth Harrison, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 13601 Se Lincoln Ct, Portland, OR 97233 Phone: 503-558-5339
Mrs. Lindsey Erin Gibson, MED Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 1110 Se Alder St Ste 301, Portland, OR 97214 Phone: 971-400-5407

Charles Dickerman, LMFT, CADC III, SUDP - Medicare Couples Therapy in Portland, OR