Healthcare Provider Details

I. General information

NPI: 1780571430
Provider Name (Legal Business Name): ASHIKA DICKERSON APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2025
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3214 UPSHUR ST
MOUNT RAINIER MD
20712-1647
US

IV. Provider business mailing address

3214 UPSHUR ST
MOUNT RAINIER MD
20712-1647
US

V. Phone/Fax

Practice location:
  • Phone: 202-952-6612
  • Fax: 202-474-4609
Mailing address:
  • Phone: 202-952-6612
  • Fax: 202-474-4609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024193837
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: