Kelly Nicole Dickerson, LCSW
NPI 1003439928ActiveIndividual· Social Worker, Clinical· Monroe, GA
Social Worker, Clinical (LCSW) with Creative Center for Wellness, Incorporated, practicing in Monroe, Georgia. Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1003439928 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LCSW |
| Sole proprietor | No |
| NPI issued | May 27, 2020 |
| Last updated in NPPES | Jul 31, 2024 |
| Certified by provider | Jul 31, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | CSW007086 | GA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (GA) |
|---|
Education and affiliations
| Graduation year | 2014 |
|---|---|
| Medicare specialty | Clinical Social Worker |
| Telehealth | Offers telehealth |
Medical group
- Creative Center for Wellness, IncorporatedMonroe, GA · 3 clinicians
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