Provider Demographics
NPI:1891138368
Name:DICKISON, LINDSEY RAE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LINDSEY
Middle Name:RAE
Last Name:DICKISON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:195 OAKLAD ST
Mailing Address - Street 2:APT C
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06042-8250
Mailing Address - Country:US
Mailing Address - Phone:860-380-0452
Mailing Address - Fax:860-358-9842
Practice Address - Street 1:175 CAPITAL BLVD
Practice Address - Street 2:FL 4
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-3914
Practice Address - Country:US
Practice Address - Phone:860-380-0452
Practice Address - Fax:860-358-9842
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-15
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical