THERESA M DICKERSON


Address: 2625 N Meridian St, Indianapolis, IN 46208-7701
Phone: 6784293197

THERESA M DICKERSON (NPI# 1689982613) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1689982613
Entity Type Individual
Full Name THERESA M DICKERSON
Credential LMT, CBW
Practice Address 2625 N Meridian St
Indianapolis
IN 46208-7701
Mailing Address 2002 Koehne St
Indianapolis
IN 46202-1042
Practice Telephone 6784293197
Mailing Telephone 6784293197
Enumeration Date 2010-09-24
Last Update Date 2010-09-24
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 225500000X Specialist/Technologist MT20901976 IN Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Y 225700000X Massage Therapist MT20901976 IN Respiratory, Developmental, Rehabilitative and Restorative Service Providers
N 173C00000X Reflexologist MT20901976 IN Other Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
IN STATE LICENSE MT20901976 01

Office Location

Street Address 2625 N MERIDIAN ST
City INDIANAPOLIS
State IN
Zip Code 46208-7701

Providers in the same location

NPI Name Taxonomy Address Enumeration
1376684134 Patrick J Perry Social Worker 2625 N Meridian St, Suite 18, Indianapolis, IN 46208-7701 2007-02-12
1679857528 Always At Home In Home Supportive Care 2625 N Meridian St, Suite 157, Indianapolis, IN 46208-7701 2011-10-10
1689961898 Jabrea Bennett Dentist 2625 N Meridian St, Apartment 307, Indianapolis, IN 46208-7701 2011-07-08
1124268131 Optimum Care Centers, LLC. Physical Medicine & Rehabilitation 2625 N Meridian St, Indianapolis, IN 46208-7701 2009-03-03
1477739191 Thomas I Mcdonough Social Worker 2625 N Meridian St, Suite 18, Indianapolis, IN 46208-7701 2008-01-11
1295853992 Psychological Laboratories of Indianapolis, PC Psychologist 2625 N Meridian St, Suite 18, Indianapolis, NE 46208 2007-03-27
1174665632 Brian Teel Psychologist 2625 N Meridian St, Suite 18, Indianapolis, IN 46208-7701 2007-02-13

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1033650924 Kristine M Sullivan Dietitian, Registered 2700 Doctor M.l.k. Jr St., Indianapolis, IN 46208 2017-03-13
1760877591 Michael A. Davis, D.d.s. Family Dental LLC Dentist 3737 N. Meridian Ste. 410, Indianapolis, IN 46208 2015-03-30
1831432574 Curtis Stennett Psychiatry & Neurology 563 W Westfield Blvd, Indianapolis, IN 46208 2013-04-01
1417206392 Planned Parenthood of Indiana Midtown Clinic/Center 3750 N. Meridian St., Suite 100, Indianapolis, IN 46208 2012-09-06
1629216932 Mary Carol Calloway Follman Occupational Therapist 5502 N. Kenwood Ave., Indianapolis, IN 46208 2009-01-23
1871760751 Jacob Odell Roberts Chiropractor 2413 N Meridian St, Indianapolis, IN 46208 2008-05-10
1285846360 Midwest Residential Services, Inc. Preferred Provider Organization 2425 N. Meridian Street, Suite B, Indianapolis, IN 46208 2007-05-03
1881814879 Cheryl Ann Moore Social Worker 3171 N. Meridian Street, Indianapolis, IN 46208 2007-05-01
1679612881 Kenneth Ackles Sr. Chiropractor 3231 North Meridian Street, Suite 502, Indianapolis, IN 46208 2007-02-05
1013062918 William D. Alexy Psychologist 6110 N. Meridian, W.dr, Indianapolis, IN 46208 2007-01-24
Find all providers in zip 46208

Taxonomy Information

Taxonomy Code 225700000X
Grouping Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification Massage Therapist

Taxonomy Definition

An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1689281297 Amanda Joy Smith Massage Therapist 4915 Rue Vallee Apt 89, Indianapolis, IN 46227-6660 2020-09-28
1154937837 Andrenique Coleman Massage Therapist 815 Hardin Blvd Apt C, Indianapolis, IN 46241-1987 2020-09-18
1255944203 Julia Piner Massage Therapist 303 S Delaware St, Indianapolis, IN 46204-3747 2020-08-28
1427660554 Michael Frederick Vermilyer Massage Therapist 4340 W 96th St Ste 101, Indianapolis, IN 46268-2920 2020-08-19
1295358208 Lona Talia Lyons Massage Therapist 335 N Harbison Ave, Indianapolis, IN 46219-5425 2020-05-26
1518593870 Robert Trevor Foote Massage Therapist 212 W 10th St # Srb215, Indianapolis, IN 46202-5401 2020-03-19
1013554625 Rebecca Marie Townsend Massage Therapist 970 Fort Wayne Ave, Indianapolis, IN 46202-4328 2019-12-02
1376188052 Shyra Cobb Massage Therapist 5471 Georgetown Rd Ste B, Indianapolis, IN 46254-5794 2019-11-17
1912541467 Starsiak Osteopathic Clinic LLC Massage Therapist 3955 Eagle Creek Pkwy Ste A, Indianapolis, IN 46254-4692 2019-10-28
1659922607 Natalie Kolanowski Massage Therapist 821 Dr Martin Luther King Jr St Apt L, Indianapolis, IN 46202-5705 2019-09-20
Find all providers in INDIANAPOLIS

Competitor

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City INDIANAPOLIS
Zip Code 46208

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Dataset Information

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.

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