DR. LATREECE EVETTE DICKERSON PSY.D.
NPI 1053409722
Psychologist - Clinical in Chicago, IL

Q: What is Latreece Dickerson's NPI number?

The NPI number for Latreece Dickerson is 1053409722. It was assigned to this individual provider in the NPPES registry on October 10, 2006.

Q: What is Latreece Dickerson's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Active since October 10, 2006PECOS EnrolledAccepts Medicare Assignment

9933 S WESTERN AVE STE 203, CHICAGO, IL 60643(312) 730-3966(312) 803-1635 Get Directions Write a Review

NPPES record last updated: November 10, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Nov 10, 2023, Mar 17, 2018, Oct 10, 2016 (3 updates tracked since 2016).

On this page

About Dr. Latreece Evette Dickerson Psy.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. LATREECE EVETTE DICKERSON PSY.D. (NPI 1053409722) is an individual clinical provider in Chicago, Illinois, licensed in Illinois (071009102) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS, maintains a secondary practice location in Chicago, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1053409722

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameDR. LATREECE EVETTE DICKERSONCredential: PSY.D.

Location Address9933 S WESTERN AVE STE 203Chicago, IL 60643-1810

Mailing Address9933 S Western Ave Ste 203Chicago, IL 60643-1810 · (312) 730-3966 · Fax (312) 803-1635

Phone(312) 730-3966

Fax(312) 803-1635

Sole ProprietorYes

Medical School CMSOtherGraduated 2013

Enumeration DateOctober 10, 2006

Last NPPES UpdateNovember 10, 20233 updates tracked since enumeration

NPPES CertifiedNovember 10, 2023

✔ NPI 1053409722 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in IL · 071009102

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X · License 149-008520 (IL)

9933 S WESTERN AVE STE 203, Chicago, IL 60643

Open in Google Maps ↗

Secondary Practice Location 1

Location 17230 S Fairfield AvenueChicago, IL 60629 · Phone (773) 440-2248

Other Identifiers 1

Other1437667805IL · Partnerships In Behavioral Health

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Latreece Evette Dickerson Psy.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID42445769

PECOS Enrollment IDI20180531002948

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Latreece Dickerson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Partnerships In Behavioral Health

Same address

Clinical

9933 S WESTERN AVE STE 203
Chicago, IL 60643

Reassigned Medicare billing, Illinois enrollment
2 clinicians in this Medicare group

NPI 1437667805 (312) 730-3966

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychotherapy, 1 hour 90837

Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 1-hour session, you'll talk about your feelings, thoughts, and behaviors to help identify and manage mental health issues. This process aids in personal growth, healing, and improved well-being.

127 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60643 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$183.39 typical visit price

range $60.08 – $183.39

Typical copayment $45.84 (range $15.02 – $45.84)

Most-billed visit code 99205

Established Patient

$105.70 typical visit price

range $18.97 – $148.12

Typical copayment $26.42 (range $4.74 – $37.03)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LATONYA DENEEN SCOTT

Counselor (Professional)

9933 S WESTERN AVE STE 203
CHICAGO, IL 60643

Cook County (312) 667-2854

PARTNERSHIPS IN BEHAVIORAL HEALTH

Psychologist (Clinical)

9933 S WESTERN AVE STE 203
CHICAGO, IL 60643

Cook County (312) 730-3966

MS. TRACELL PARKER LCSW

Social Worker (Clinical)

9933 S WESTERN AVE STE 203
CHICAGO, IL 60643

Cook County (312) 730-3966

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Latreece Dickerson's NPI number?

The NPI number for Latreece Dickerson is 1053409722. It was assigned to this individual provider in the NPPES registry on October 10, 2006.

Where is Latreece Dickerson located?

Latreece Dickerson practices at 9933 S Western Ave Ste 203, Chicago, IL 60643. The listed phone number is (312) 730-3966.

What is Latreece Dickerson's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Latreece Dickerson enrolled in Medicare?

Yes. Latreece Dickerson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Latreece Dickerson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Latreece Dickerson reassigns Medicare benefits to Partnerships In Behavioral Health (Chicago, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Latreece Dickerson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Latreece Dickerson accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Latreece Dickerson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Latreece Dickerson was last updated on November 10, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.