Provider Demographics
NPI:1942413968
Name:DICKERSON, JULIE (MS, LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:
Last Name:DICKERSON
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 108
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:AR
Mailing Address - Zip Code:71929-0108
Mailing Address - Country:US
Mailing Address - Phone:501-627-8385
Mailing Address - Fax:501-865-3362
Practice Address - Street 1:3399 FINCH ROAD
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:AR
Practice Address - Zip Code:71929
Practice Address - Country:US
Practice Address - Phone:501-865-3363
Practice Address - Fax:501-865-3362
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP0010028101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional