MS. KYOUNG HI SONG DICKSON LMFT
NPI 1306134275
Marriage & Family Therapist in Bristol, CT

Active since July 13, 2011Opted out of Medicare · through Sep 26, 2026
38 KELLEY ST, BRISTOL, CT 06010(860) 314-1236(860) 314-1236 Get Directions Write a Review

NPPES record last updated: July 13, 2011. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Ms. Kyoung Hi Song Dickson Lmft NPPES

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

MS. KYOUNG HI SONG DICKSON LMFT (NPI 1306134275) is an individual marriage & family therapist in Bristol, Connecticut, licensed in Connecticut (001459) and active in the NPI registry since July 2011. She has opted out of Medicare through September 26, 2026.

NPPES Registry Identity

NPI1306134275
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NameMS. KYOUNG HI SONG DICKSONCredential: LMFT
Location Address38 KELLEY STBristol, CT 06010-5715
Mailing Address38 Kelley StreetBristol, CT 06107 · (860) 314-1236 · Fax (860) 314-1236
Fax(860) 314-1236
Sole ProprietorYes
Enumeration DateJuly 13, 2011
NPI 1306134275 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
License Licensed in CT · 001459
Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

38 KELLEY ST, Bristol, CT 06010

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Ms. Kyoung Hi Song Dickson Lmft has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from September 26, 2024 through September 26, 2026.

Opt-Out Effective DateSeptember 26, 2024
Opt-Out In Effect ThroughSeptember 26, 2026Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 6

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

Marriage & Family Therapist
38 KELLEY ST
BRISTOL, CT 06010
Marriage & Family Therapist
38 KELLEY ST
BRISTOL, CT 06010
Marriage & Family Therapist
38 KELLEY ST, THE FAMILY THERAPY CENTER
BRISTOL, CT 06010
Marriage & Family Therapist
38 KELLEY ST
BRISTOL, CT 06010
Social Worker (Clinical)
38 KELLEY ST
BRISTOL, CT 06010
Social Worker (Clinical)
38 KELLEY ST
BRISTOL, CT 06010

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1306134275, enumerated as an "individual" on July 13, 2011.

The provider is located at 38 KELLEY ST BRISTOL, CT 06010 and the phone number is (860) 314-1236.

Marriage & Family Therapist with taxonomy code 106H00000X.

The provider might be accepting Accepts: Providence Health Plan. Please consult your insurance carrier or call the provider to verify.