Provider Demographics
NPI:1083183586
Name:DICKEY, KRISTIE N (LPC)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIE
Middle Name:N
Last Name:DICKEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KRISTIE
Other - Middle Name:N
Other - Last Name:CARDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 614
Mailing Address - Street 2:
Mailing Address - City:WARRENSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:64093-0614
Mailing Address - Country:US
Mailing Address - Phone:816-217-5458
Mailing Address - Fax:
Practice Address - Street 1:510 E GAY ST STE E
Practice Address - Street 2:
Practice Address - City:WARRENSBURG
Practice Address - State:MO
Practice Address - Zip Code:64093-3107
Practice Address - Country:US
Practice Address - Phone:816-217-5458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-14
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016007295101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional