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Nicole Dickerson
Peer Specialist in Lincoln City, Oregon
NPI 1184407629

Nicole Dickerson is a Peer Specialist based in Newport, OR. Nicole Dickerson practices in Lincoln City, OR. The NPI Number for Nicole Dickerson is 1184407629 and holds a License No. 22-CRM-1313 (Oregon).

The current practice location address for Nicole Dickerson is 1345 Nw 15Th St, Lincoln City, OR and can be reached out via phone at 541-574-9570 and via fax at 541-574-8857.

Location: 1345 Nw 15Th St, Lincoln City, OR, 97365-0115
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1184407629
Provider Name
Nicole Dickerson
Credential
Provider Entity Type
Individual
Gender
Female
Address
1345 Nw 15Th St, Lincoln City, OR, 97365-0115
Phone Number
541-574-9570
Fax Number
541-574-8857
Provider Enumeration Date
08/17/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1345 Nw 15Th St
City
Lincoln City
State
Oregon
Zip
97367-3327
Phone Number
541-574-9570
Fax Number
541-574-8857
person
Provider Business Mailing Address Details
Address
1345 Nw 15Th St
City
Lincoln City
State
Oregon
Zip
97367-3327
Phone Number
541-574-9570
Fax Number
541-574-8857
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
22-CRM-1313 (Oregon)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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