MR. JOSEPH LEE DICKERSON JR. M. ED
NPI 1780029165
Counselor in Manchester, CT
About Mr. Joseph Lee Dickerson Jr. M. Ed NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. JOSEPH LEE DICKERSON JR. M. ED (NPI 1780029165) is an individual counselor in Manchester, Connecticut, licensed in Connecticut (C022013000914) and active in the NPI registry since April 2013. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mr. Joseph Lee Dickerson Jr. M. Ed is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Joseph Dickerson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Manchester, CT 06042
- Reassigned Medicare billing, Connecticut enrollment
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Joseph Dickerson's NPI number?
The NPI number for Joseph Dickerson is 1780029165. It was assigned to this individual provider in the NPPES registry on April 30, 2013.
Where is Joseph Dickerson located?
Joseph Dickerson practices at 872 Vernon St, Manchester, CT 06042. The listed phone number is (860) 882-9117.
What is Joseph Dickerson's specialty?
The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.
Is Joseph Dickerson enrolled in Medicare?
Yes. Joseph Dickerson is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Joseph Dickerson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Joseph Dickerson reassigns Medicare benefits to Dickerson Enterprise LLC (Manchester, CT). 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 Joseph Dickerson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Joseph Dickerson was last updated on April 30, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.
# Mr. Joseph Lee Dickerson Jr., M. ED · NPI 1780029165
Counselor provider in Manchester, Connecticut. Individual provider, active in the CMS NPPES registry since April 30, 2013.
## Identity
- **NPI:** 1780029165 (Entity type: Individual)
- **Enumerated:** April 30, 2013
- **Primary specialty:** Counselor · taxonomy 101Y00000X
- **State license:** C022013000914 (Connecticut)
- **Sole proprietor:** No
## Practice location
- **Address:** 872 VERNON ST, Manchester, CT 06042-2415
- **Phone:** (860) 882-9117
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Dickerson Enterprise LLC (NPI 1669993663, Manchester, CT), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 30, 2013
---
Source: [NPI Profile](https://npiprofile.com/npi/1780029165) · Data from the CMS NPPES public registry.