Provider Demographics
NPI:1356954879
Name:DICKSON, NGOZIKA
Entity type:Individual
Prefix:
First Name:NGOZIKA
Middle Name:
Last Name:DICKSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GOZI
Other - Middle Name:
Other - Last Name:DICKSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:13915 GOLD CIR STE 100
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-2359
Mailing Address - Country:US
Mailing Address - Phone:402-709-8338
Mailing Address - Fax:
Practice Address - Street 1:13915 GOLD CIR STE 100
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-2359
Practice Address - Country:US
Practice Address - Phone:402-709-8338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-25
Last Update Date:2025-11-19
Deactivation Date:2025-09-25
Deactivation Code:
Reactivation Date:2025-10-30
Provider Licenses
StateLicense IDTaxonomies
NE14603101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health