Healthcare Provider Details

I. General information

NPI: 1376966002
Provider Name (Legal Business Name): VALERIE DAWKINS LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2014
Last Update Date: 01/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 MECHANICS VALLEY RD
NORTH EAST MD
21901-3824
US

IV. Provider business mailing address

PO BOX 109
BEL AIR MD
21014-0109
US

V. Phone/Fax

Practice location:
  • Phone: 410-569-9497
  • Fax: 410-569-0094
Mailing address:
  • Phone: 410-569-9497
  • Fax: 410-569-0094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC5263
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: