KATHERINE RUTH DICKERSON LCMHCS, LCAS, CCS
NPI 1780816603
Counselor - Mental Health in Denver, NC

Q: What is Katherine Dickerson's NPI number?

The NPI number for Katherine Dickerson is 1780816603. It was assigned to this individual provider in the NPPES registry on August 11, 2009. The provider is also known as Katherine R Pedraza Ms, Lcas.

Q: What is Katherine Dickerson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Active since August 11, 2009PECOS Enrolled

7490 WATERSIDE CROSSING BLVD STE 2A, DENVER, NC 28037(704) 360-3637(704) 625-9789 Get Directions Write a Review

NPPES record last updated: December 15, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Katherine Ruth Dickerson Lcmhcs, Lcas, Ccs NPPES

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

KATHERINE RUTH DICKERSON LCMHCS, LCAS, CCS (NPI 1780816603) is an individual mental health provider in Denver, North Carolina, licensed in North Carolina (S9956) and active in the NPI registry since August 2009. She is enrolled in Medicare PECOS and maintains a secondary practice location in Mooresville.

NPPES Registry Identity

NPI1780816603

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameKATHERINE RUTH DICKERSONCredential: LCMHCS, LCAS, CCS

Location Address7490 WATERSIDE CROSSING BLVD STE 2ADenver, NC 28037-3004

Mailing Address7490 Waterside Crossing Blvd Ste 2aDenver, NC 28037-3004 · (704) 360-3637 · Fax (704) 625-9789

Phone(704) 360-3637

Fax(704) 625-9789

Sole ProprietorNo

Enumeration DateAugust 11, 2009

Last NPPES UpdateDecember 15, 2023

NPPES CertifiedDecember 15, 2023

✔ NPI 1780816603 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

Licenses✔ Licensed in NC · S9956✔ Licensed in NC · CCS-10965

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License LCAS-1406 (NC), CCS-10965 (NC)

7490 WATERSIDE CROSSING BLVD STE 2A, Denver, NC 28037

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Other Names 1

Former Name (1)Katherine R Pedraza Ms, Lcas

Secondary Practice Location 1

Location 1122 Gateway Blvd Ste CMooresville, NC 28117-5544 · Phone (704) 360-3637 · Fax (704) 200-9829

Other Identifiers 1

Medicaid3112086NC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, Oscar Health Plan of North Carolina, Inc.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

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Enrolled in Medicare (PECOS)

Katherine Ruth Dickerson Lcmhcs, Lcas, Ccs is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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Other Providers at the Same Location NPPES 13

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

ROBERT BRUCE RISAVI LCSW

Social Worker (Clinical)