Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1295113694 Individual Practitioner Male Practitioner

Jeremy W Dickson , MA, LPC

Counselor • Springfield, MO

Professional Overview & Biography Verified Profile Summary

Jeremy Dickson, MA, LPC is a registered healthcare professional specializing in Counselor in Springfield, MO. Practice services are available at 323 E GRAND ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

323 E Grand St

Springfield, MO 65807

Telephone 4177615600
Fax 4177615601
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor in Springfield, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 21.5 Yrs
State Avg: 16.1 Yrs
Regional Practice Density
88 Specialists

Practicing in Springfield, MO (1111 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2020-09-14
Counselor Primary Specialty

NUCC Taxonomy Code: 101Y00000X

State License MO 2015014046

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
490021929 (MO)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

7 Associated Practitioners
Shay Davis , FNP

Nurse Practitioner - Family

NPI 1063999464

Family Nurse Practitioner

Justin Fleming , MS, LPC, NCC

Counselor - Professional

NPI 1184189789

Master of Science, Licensed Professional Counselor, National Certified Counselor

Dr. Tedra Estis , DNP, FPMHNP

Nurse Practitioner - Psychiatric/Mental Health

NPI 1548612468

Doctor of Nursing Practice, FPMHNP

Dr. Diane Ellis , PsyD, LP

Psychologist - Clinical

NPI 1770527426

Doctor of Psychology (Psy.D.), Licensed Psychologist

Andrew Phelps , LMSW

Social Worker - Clinical

NPI 1770843401

Licensed Master Social Worker

Cristin Martinez , MS, LPC

Counselor - Professional

NPI 1942523493

Master of Science, Licensed Professional Counselor

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

16 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 22, 2019

Counselor (License #2015014046 in MO)

📍
Updated Practice Location June 20, 2018

Registered at 323 E GRAND ST, SPRINGFIELD, MO 65807 (Tel: 4177615600)

👤
Provider Name / Credentials Updated June 20, 2018

Recorded as JEREMY DICKSON, MA, LPC

📍
Updated Practice Location May 11, 2018

Registered at 323 E GRAND ST, SPRINGFIELD, MO 658071447 (Tel: 4177615600)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 11, 2018

Counselor (License #2015014046 in MO)

NPI Profile Active March 23, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location March 23, 2017

Registered at 1300 E BRADFORD PKWY, SPRINGFIELD, MO 658044264 (Tel: 4177615000)

📍
Updated Business Mailing Address March 23, 2017

Registered at 1300 E BRADFORD PKWY, SPRINGFIELD, MO 658044264 (Tel: 4177615000)

👤
Provider Name / Credentials Updated March 23, 2017

Recorded as JEREMY DICKSON, PLPC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 23, 2017

Counselor

NPI Profile Active May 18, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location May 18, 2015

Registered at 3050 S NATIONAL AVE STE 104, SPRINGFIELD, MO 658044242 (Tel: 4175974572)

📍
Updated Business Mailing Address May 18, 2015

Registered at 310 WINSLOW DR, HIGHLANDVILLE, MO 656698253 (Tel: 4175974572)

👤
Provider Name / Credentials Updated May 18, 2015

Recorded as JEREMY DICKSON

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 18, 2015

Counselor

🟢
Initial NPI Registration & Enumeration May 18, 2015

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1295113694
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 18, 2015
Last Update: September 14, 2020
Sole Proprietor: No

Mailing Address

1300 E Bradford Pkwy

Springfield, MO 658044264

Phone: 4177615000

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.