1740236462 NPI number — MS. CAROLYN G DAWKINS LCSWC

Table of content: MS. CAROLYN G DAWKINS LCSWC (NPI 1740236462)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740236462 NPI number — MS. CAROLYN G DAWKINS LCSWC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DAWKINS
Provider First Name:
CAROLYN
Provider Middle Name:
G
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSWC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SAPP
Provider Other First Name:
CAROLYN
Provider Other Middle Name:
D
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1740236462
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/28/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9006 WOODYARD RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLINTON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20735-4206
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-856-3636
Provider Business Mailing Address Fax Number:
301-856-3633

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9006 WOODYARD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLINTON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20735-4206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-856-3636
Provider Business Practice Location Address Fax Number:
301-856-3633
Provider Enumeration Date:
05/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  09930 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 408609100 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 454CDI . This is a "CAREFIRST BC/BS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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