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Individual

VALENCIA DESHANE DICKERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPCC

Contact information

Practice address
525 W 5TH ST, COVINGTON, KY 41011-1259
(606) 356-9741
Mailing address
677 HAWTHORNE AVE, CINCINNATI, OH 45205-2318
(606) 356-9741

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
243847
KY
101YM0800X
Mental Health Counselor
243847
KY
101YP2500X
Professional Counselor
Primary
243847
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100591700
KY
Enumeration date
11/06/2018
Last updated
04/30/2019
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