Healthcare Provider Details

I. General information

NPI: 1215848445
Provider Name (Legal Business Name): SHANIKA DICKEY QMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 9003
RICHMOND VA
23225-0703
US

IV. Provider business mailing address

PO BOX 9003
RICHMOND VA
23225-0703
US

V. Phone/Fax

Practice location:
  • Phone: 804-351-7495
  • Fax: 804-800-2087
Mailing address:
  • Phone: 804-351-7495
  • Fax: 804-800-2087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0732006055
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: