Provider Demographics
NPI:1912225830
Name:DICKEY, ROBERT ADAM (PSYD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ADAM
Last Name:DICKEY
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20385 BUTTERMILK
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-9490
Mailing Address - Country:US
Mailing Address - Phone:503-734-8261
Mailing Address - Fax:
Practice Address - Street 1:20385 BUTTERMILK
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-9490
Practice Address - Country:US
Practice Address - Phone:503-734-8261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-17
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2618103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty