Provider Demographics
NPI:1619774825
Name:DICKENS, MICHEAL AARON (LPC)
Entity type:Individual
Prefix:DR
First Name:MICHEAL
Middle Name:AARON
Last Name:DICKENS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:DR
Other - First Name:HAROLD
Other - Middle Name:C
Other - Last Name:DICKENS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:1507 DOVE CIR
Mailing Address - Street 2:
Mailing Address - City:ENNIS
Mailing Address - State:TX
Mailing Address - Zip Code:75119-1747
Mailing Address - Country:US
Mailing Address - Phone:469-550-8345
Mailing Address - Fax:
Practice Address - Street 1:1507 DOVE CIR
Practice Address - Street 2:
Practice Address - City:ENNIS
Practice Address - State:TX
Practice Address - Zip Code:75119-1747
Practice Address - Country:US
Practice Address - Phone:469-550-8345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-26
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89686101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTX022199004OtherLICENSE NUMBER