Individual
NICOLE ANNE DICKASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
370 E HERSEY ST, ASHLAND, OR 97520-2361
(541) 476-2373
Mailing address
1215 SW G ST, GRANTS PASS, OR 97526-2544
(541) 476-2373
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
OR
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122994
—
OR
Enumeration date
10/15/2024
Last updated
07/09/2026
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