Healthcare Provider Details

I. General information

NPI: 1558692020
Provider Name (Legal Business Name): DAPHNE T. DODSON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2010
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 E MOUND ST
COLUMBUS OH
43215-5595
US

IV. Provider business mailing address

455 E MOUND ST
COLUMBUS OH
43215-5595
US

V. Phone/Fax

Practice location:
  • Phone: 614-242-1284
  • Fax: 614-242-1285
Mailing address:
  • Phone: 614-242-1284
  • Fax: 614-242-1285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberC.0003862
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.0003862
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC3862
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: