Individual
DR. CODY WILLIAM DICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, LPC, NCC
Contact information
Practice address
3805 22ND ST STE 1C, LUBBOCK, TX 79410-1142
(806) 252-6633
Mailing address
4510 IRONTON AVE APT 3201, LUBBOCK, TX 79407-3783
(806) 252-6633
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
5222
NE
101YP2500X
Professional Counselor
Primary
69897
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
338488501
—
TX
01
—
5222
NEBRASKA DHHS LICENSURE UNIT
NE
01
—
69897
TEXAS STATE BOARD OF EXAMINERS OF PROFESSIONAL COUNSELORS
TX
Enumeration date
07/24/2014
Last updated
09/13/2019
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