SHADE DICKSON (NPI# 1497137897) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497137897 |
| Entity Type | Individual |
| Full Name | SHADE DICKSON |
| Practice Address |
1330 N Black Horse Pike Suite D Williamstown NJ 08094-9160 |
| Mailing Address |
1123 Tara Dr Williamstown NJ 08094-3591 |
| Practice Telephone | 8562621200 |
| Mailing Telephone | 8562621200 |
| Mailing Fax Number | 8562621204 |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2015-06-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | 474254341 | NJ | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 474254341 | 05 |
| Street Address |
1330 N BLACK HORSE PIKE SUITE D |
| City | WILLIAMSTOWN |
| State | NJ |
| Zip Code | 08094-9160 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821457060 | Supportive Care Management, LLC | Case Management | 1330 N Black Horse Pike, Suite- C, Williamstown, NJ 08094-9160 | 2016-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598307068 | A Helping Hand Services Inc. | Psychologist | 208 Brandywine Dr., Williamstown, NJ 08094 | 2019-10-16 |
| 1558843920 | Ngozi Oluchi Amugo | Nurse Practitioner | 1005 Cezanne Ct, Williamstown, NJ 08094 | 2018-09-03 |
| 1962913111 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1767 Forest Drive, Williamstown, NJ 08094 | 2017-10-16 |
| 1841701091 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1848 Herbert Boulevard, Williamstown, NJ 08094 | 2017-10-16 |
| 1659747350 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community/Behavioral Health | 1040 North Tuckahoe Road, Tuckahoe House, Williamstown, NJ 08094 | 2015-08-17 |
| 1891161774 | Assoc. for Retarded Citizens. Inc. Gloucester County | Respite Care | 1036 North Tuckahoe Road, Camp Sun N' Fun, Williamstown, NJ 08094 | 2015-08-14 |
| 1972989184 | Ismile Dental Arts, PC | Clinic/Center | 368 Berlin Cross Keys Rd, Williamstown, NJ 08094 | 2015-08-11 |
| 1437534542 | Walgreens | Pharmacy | 13 North Black Horse Pike, Williamstown, NJ 08094 | 2015-07-30 |
| 1144625468 | Lauren Degrazia | Behavioral Analyst | 1880 Glassboro Rd., Williamstown, NJ 08094 | 2014-10-29 |
| 1558601765 | Monroe Township Public School District | Local Education Agency (LEA) | 75 E. Academy Street, Williamstown, NJ 08094 | 2013-02-25 |
| Find all providers in zip 08094 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598276602 | Bolla Adeboye | Case Manager/Care Coordinator | 1019 Dartmoor Ave, Williamstown, NJ 08094-6311 | 2017-10-16 |
| 1063747368 | People for People Support Coordination | Case Manager/Care Coordinator | 141 Carter Blvd, Williamstown, NJ 08094 | 2009-10-05 |
| 1578163325 | Amanda Bartlett | Case Manager/Care Coordinator | 1307 Williamstown Pike, Williamstown, WV 26187-8168 | 2020-10-30 |
| 1609255579 | Rhonda Asher | Case Manager/Care Coordinator | 308 Barnes Rd, Williamstown, KY 41097-9483 | 2015-05-26 |
| 1376969980 | Joseph Tuggle | Case Manager/Care Coordinator | 308 Barnes Rd, Williamstown, KY 41097-9483 | 2014-03-07 |
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| 1144832452 | Laura Walker-talbot | Case Manager/Care Coordinator | 675 Washington Ave, Woodbury, NJ 08096-3544 | 2020-08-18 |
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| 1205458833 | Jane Preguica | Case Manager/Care Coordinator | 785 Chestnut St, Union, NJ 07083-9317 | 2020-05-18 |
| 1679192421 | Fiscally Responsible LLC | Case Manager/Care Coordinator | 175 Elmwood Dr, Clifton, NJ 07013-1129 | 2020-04-12 |
| 1285260885 | Ashley Elizabeth Gery | Case Manager/Care Coordinator | 1580 U.S. 9, Cape May Court House, NJ 08210 | 2020-03-16 |
| 1669008405 | Alt Best Practices Bhom2, LLC | Case Manager/Care Coordinator | 81 Crooked Stick Rd, Jackson, NJ 08527-4032 | 2020-03-12 |
| Find all providers with the same taxonomy | ||||
| City | WILLIAMSTOWN |
| Zip Code | 08094 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.