=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881518298
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | REAGAN DICKSON
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/07/2026
-----------------------------------------------------
Last Update Date | 08/07/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 125 FM 2450
-----------------------------------------------------
City | KRUM
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76249
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 940-482-2602
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 401 AME DR APT 5208
-----------------------------------------------------
City | DENTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76207-7687
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-659-8917
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 96512
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YS0200X
-----------------------------------------------------
Taxonomy Name | School Counselor
-----------------------------------------------------
License Number | 2290241
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------