MEDICARE: JACOB DICKERSON LPC, RPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	A1704202	AR

General Provider Information

NPI Number	:	1679940597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACOB DICKERSON LPC, RPT

Provider Business Mailing Address
First Line	:	7232 HIGHWAY 7
Second Line	:
City	:	BISMARCK
State	:	AR
Zip	:	71929-7105
Country	:	US
Telephone Number	:	501-627-2503
Fax Number	:	501-222-1282

Provider Business Practice Location Address
First Line	:	100 RIDGEWAY ST STE 1
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71901-7155
Country	:	US
Telephone Number	:	501-627-2503
Fax Number	:	501-222-1282

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2015
Last Update Date	:	06/02/2023

Similar Medicare Providers

1245710532 — PREMISE HEALTH OF ARKANSAS MEDICAL PA
Practice Location Address:

100 RIDGEWAY ST STE 2
HOT SPRINGS, AR
71901-7155

Practice Phone: 501-318-0016
Practice Fax: 501-318-0059

1497735120 — MRS. TERI L. SMITH APRN
Practice Location Address:

100 RIDGEWAY ST STE 2
HOT SPRINGS NATIONAL PARK, AR
71901-7155

Practice Phone: 501-623-2426
Practice Fax: 501-623-2405

1043282056 — MS. BEVERLY J. TRICKEY LPC
Practice Location Address:

100 RIDGEWAY ST STE 1
HOT SPRINGS, AR
71901-7155

Practice Phone: 501-860-1114
Practice Fax: 501-623-2266

1417027079 — SHANNON MCCLARD M.A., L.P.E
Practice Location Address:

100 RIDGEWAY ST STE 1
HOT SPRINGS, AR
71901-7155

Practice Phone: 501-760-8333
Practice Fax: 501-623-2266

1366685315 — THADDEUS ELDER LPC
Practice Location Address:

100 RIDGEWAY ST STE 1
HOT SPRINGS, AR
71901-7155

Practice Phone: 501-545-6420
Practice Fax: 501-623-2266

1982047940 — KARA JOY WAY M.D.
Practice Location Address:

100 RIDGEWAY ST STE 2
HOT SPRINGS NATIONAL PARK, AR
71901-7155

Practice Phone: 501-623-2426
Practice Fax: 501-623-2405

Directions to “ JACOB DICKERSON LPC, RPT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.