Provider Demographics
NPI:1437222726
Name:DICKINSON, JOHN SCOTT (LMHC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:SCOTT
Last Name:DICKINSON
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 10TH ST SW
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:IA
Mailing Address - Zip Code:50677-2925
Mailing Address - Country:US
Mailing Address - Phone:319-352-2064
Mailing Address - Fax:319-352-2329
Practice Address - Street 1:111 10TH ST SW
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:IA
Practice Address - Zip Code:50677-2925
Practice Address - Country:US
Practice Address - Phone:319-352-2064
Practice Address - Fax:319-352-2329
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00859101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health