Healthcare Provider Details

I. General information

NPI: 1043483472
Provider Name (Legal Business Name): PAMELA RENEE DUKES MHS, CAC-AD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2008
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1002 E PATAPSCO AVE
BALTIMORE MD
21225-2229
US

IV. Provider business mailing address

PO BOX 2727
BALTIMORE MD
21225-0727
US

V. Phone/Fax

Practice location:
  • Phone: 443-831-0191
  • Fax: 410-355-3971
Mailing address:
  • Phone: 443-831-0191
  • Fax: 410-355-2350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC16806
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLGPC200001920
License Number StateDC
# 5
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberAC0806
License Number State
# 6
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLGPC200001920
License Number StateDC
# 7
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 8
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC16806
License Number StateMD
# 9
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCACII200001274
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: