Provider Demographics
NPI:1518219963
Name:DICKSON, JAMIE (PSYD)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:
Last Name:DICKSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5259 VERNON SPRINGS TRL NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-4511
Mailing Address - Country:US
Mailing Address - Phone:404-276-1575
Mailing Address - Fax:
Practice Address - Street 1:5259 VERNON SPRINGS TRL NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-4511
Practice Address - Country:US
Practice Address - Phone:404-276-1575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-10
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY003318103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical