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General NPI Number Information
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NPI Number | 1932572104
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Entity Type | Individual
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Provider Name | DWAN PINCKNEY LMHC
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Gender | Female
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Dates
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Enumeration Date | 11/09/2015
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Last Update Date | 08/12/2023
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Provider Practice Location Address
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Address Line | 8540 BAYCENTER RD
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City | JACKSONVILLE
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State | FL
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Zip | 32256-7420
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Country | US
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Telephone | 904-448-1933
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Fax |
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Provider Business Mailing Address
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Address Line | 8540 BAYCENTER RD
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City | JACKSONVILLE
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State | FL
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Zip | 32256-7420
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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