| Doctor Name: | KELLY SUE DICKINSON |
| NPI Number: | 1528386372 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LICSW, LSCSW |
| License Number: | 15156 |
| Business Practice Address: | 201 Main St Suite 100 Atchison, KS - 660022838 |
| Business Phone Number: | 9133671593 |
| Business Fax Number: | 9133671627 |
| Mailing Address: | 201 Main St, Suite 100 ATCHISON |
| State: | KS |
| Postal Code: | 660022838 |
| Phone Number: | 9133671593 |
| Fax Number: | 9133671627 |
| NPI Enumeration Date: | 05/04/2010 |
| NPI Last Update Date: | 12/03/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 15156 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |