Dickess, Miranda A

Dickess, Miranda A is an individual health care provider with primary practice located at 700 Park Ave , Ironton OH 45638. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Dickess, Miranda A can be contacted via phone (740) 532-1613.

Contact Information

Primary practice address
700 Park Ave Ironton OH 45638
Phone: (740) 532-1613
Fax: (740) 532-1715
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X S.1701362 Ohio
Behavioral Health & Social Service Providers / Clinical 1041C0700X I.2002359 Ohio

Profile Details

NPI number 1578073573
LBN Legal business name Dickess, Miranda A
Credentials LISW-S
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2017
Last updated Nov 8th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578073573 NPPES
Ohio MEDICAID 0290702

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