| Augustus C. Dickens | |
|
9811 Mallard Dr Laurel MD 20708-3143 | |
| (301) 257-1430 | |
| Not Available |
| Full Name | Augustus C. Dickens |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 9811 Mallard Dr, Laurel, Maryland |
| Authorized Official Name and Position | Augustus Chadwyck Dickens (LICENSE CLINICAL PROFESSIONAL COUN) |
| Authorized Official Contact | 3012571430 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Augustus C. Dickens 1417 Winter Pine Trl Severn MD 21144-1506 Ph: (301) 257-1430 | Augustus C. Dickens 9811 Mallard Dr Laurel MD 20708-3143 Ph: (301) 257-1430 |
| NPI Number | 1851772032 |
|---|---|
| Provider Enumeration Date | 06/14/2015 |
| Last Update Date | 06/14/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851772032 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | LC6378 (Maryland) | Primary |
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