Healthcare Provider Details

I. General information

NPI: 1881958353
Provider Name (Legal Business Name): TERENCE DEXTER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2012
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4645 NANNIE HELEN BURROUGHS AVE NE
WASHINGTON DC
20019-3622
US

IV. Provider business mailing address

5200 DEVONPORT CT
GLENN DALE MD
20769-9141
US

V. Phone/Fax

Practice location:
  • Phone: 202-506-0416
  • Fax:
Mailing address:
  • Phone: 202-506-0416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN1013669
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN1013669
License Number StateDC
# 4
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberNP1013669
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: