Provider Demographics
NPI:1326260670
Name:DICKEY, DENISE ANNE (LPC)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:ANNE
Last Name:DICKEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:
Other - Last Name:ANDES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:138 RIDGECREST DRIVE
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505
Mailing Address - Country:US
Mailing Address - Phone:505-438-9592
Mailing Address - Fax:505-438-9592
Practice Address - Street 1:138 RIDGECREST DRIVE
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505
Practice Address - Country:US
Practice Address - Phone:505-438-9592
Practice Address - Fax:505-438-9592
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0929101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health