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General NPI Number Information
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NPI Number | 1326175613
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Entity Type | Organization
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Legal Business Name | STURGES DODGE, LCSW, P.A.
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 512 NEW CASTLE STREET EXTENDED
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City | REHOBOTH BEACH
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State | DE
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Zip | 19971-1839
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Country | US
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Telephone | 302-227-1446
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Fax | 302-227-1446
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Provider Business Mailing Address
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Address Line | 512 NEW CASTLE STREET EXTENDED
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City | REHOBOTH BEACH
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State | DE
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Zip | 19971-1839
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Country | US
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Telephone | 302-227-1446
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Fax | 302-227-1446
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. MARY STURGES DODGE
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Credential | LCSW
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Telephone | 302-227-1446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | Q1-0000576
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License Number State | DE
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