Provider Demographics
NPI:1154329639
Name:DICKSON, GINGER RHEA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:GINGER
Middle Name:RHEA
Last Name:DICKSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6245 LOCKE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76116-4636
Mailing Address - Country:US
Mailing Address - Phone:817-291-0141
Mailing Address - Fax:817-732-5022
Practice Address - Street 1:6245 LOCKE AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76116-4636
Practice Address - Country:US
Practice Address - Phone:817-291-0141
Practice Address - Fax:817-732-5022
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-08
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15579101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health