Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Phyllis L Dickerson, LCSW

Individual provider Clinical Social Worker · NPI 1114204807

Phyllis L Dickerson, LCSW is a Clinical Social Worker in Gulfport, Mississippi. Qualified in 1980, 46 years ago. Works from 2 locations and accepts Medicare assignment. Licensed in Alabama and Mississippi.

Years since qualifying
46
Licensed in
AL, MS
In the registry since
2011
Specialties on file
2
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

8990 Lorraine Rd
Gulfport, MS 39503-4176
Phone: (228) 331-3310
Fax: (228) 284-1608
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 301 Fisher St, Keesler Afb, MS 39534-2508 — (228) 376-3395

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence C (MS)
Clinical Social Worker Taxonomy 1041C0700X · Licence 2253C (AL)

Record details

NPI number1114204807
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedNovember 8, 2011
Last updated in NPPESJuly 21, 2022
Mailing address8990 Lorraine Rd, Gulfport, MS 39503-4176

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1980 (46 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Gulfport