Healthcare Provider Details
I. General information
NPI: 1215529839
Provider Name (Legal Business Name): DREAMS BEYOND, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/04/2021
Last Update Date: 06/16/2021
Certification Date: 06/16/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 OLYMPIC PL STE 900
TOWSON MD
21204-4113
US
IV. Provider business mailing address
PO BOX 20099
TOWSON MD
21284-0099
US
V. Phone/Fax
- Phone: 443-500-8871
- Fax:
- Phone: 443-500-8871
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
CHEKESHA
DIXON
Title or Position: CEO
Credential: LCSW-C
Phone: 443-500-8871