| Dickinson Psychological Services Pa | |
|
318a E Main St Havelock NC 28532-2214 | |
| (252) 447-7764 | |
| Not Available |
| Full Name | Dickinson Psychological Services Pa |
|---|---|
| Speciality | Psychologist |
| Location | 318a E Main St, Havelock, North Carolina |
| Authorized Official Name and Position | Patricia S Dickinson (OWNER) |
| Authorized Official Contact | 2524477764 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dickinson Psychological Services Pa 318a E Main St Havelock NC 28532-2214 Ph: (252) 447-7764 | Dickinson Psychological Services Pa 318a E Main St Havelock NC 28532-2214 Ph: (252) 447-7764 |
| NPI Number | 1417115429 |
|---|---|
| Provider Enumeration Date | 05/27/2008 |
| Last Update Date | 06/13/2014 |
| Medicare PECOS PAC ID | 2365666336 |
|---|---|
| Medicare Enrollment ID | O20140612001612 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417115429 | NPI | - | NPPES |
| 045JF | Other | NC | BCBS |
| 6000180 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 2670 (North Carolina) | Secondary |
| 103TC0700X | Psychologist - Clinical | 2670 (North Carolina) | Primary |
| Provider Name | Patricia S Dickinson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962496190 PECOS PAC ID: 6204871494 Enrollment ID: I20050628000733 |
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