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NPI Code Detail

MEDICARE: JEROME D. DINGLE LCSW

MEDICARE: JEROME D. DINGLE LCSW
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
1101YM0800XMental Health Counselor
2101YP2500XProfessional CounselorCSW008544GA
3101YM0800XMental Health CounselorCSW008544GA
4101Y00000XCounselorCSW008544GA

General Provider Information

NPI Number : 1942856976
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEROME D. DINGLE LCSW
Provider Business Mailing Address
First Line : 2022 15TH AVE
Second Line :
City : COLUMBUS
State : GA
Zip : 31901-1699
Country : US
Telephone Number : 706-496-5006
Fax Number : 706-649-6521
Provider Business Practice Location Address
First Line : 2022 15TH AVE
Second Line :
City : COLUMBUS
State : GA
Zip : 31901-1699
Country : US
Telephone Number : 706-649-6500
Fax Number : 706-649-6521
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2019
Last Update Date : 04/16/2023

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