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NPI Code Detail

MEDICARE: MS. COURTNEY NICOLE DICKENSHEET MA, LPC

MEDICARE: MS. COURTNEY NICOLE DICKENSHEET MA, LPC
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1740513738
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. COURTNEY NICOLE DICKENSHEET MA, LPC
Provider Business Mailing Address
First Line : 2725 RUSTIC RD
Second Line :
City : EDMOND
State : OK
Zip : 73034-2016
Country : US
Telephone Number : 405-570-2453
Fax Number :
Provider Business Practice Location Address
First Line : 925 CEDAR LAKE BLVD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73114-7813
Country : US
Telephone Number : 405-570-2453
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2009
Last Update Date : 12/01/2016

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