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Individual

MRS. JUDITH COATES DICKENS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MPA MS LPC LCAS CCS

Contact information

Practice address
111 WINDEL DR STE 205, RALEIGH, NC 27609-4477
(919) 610-5172
(919) 896-7957
Mailing address
5405 FIELDSTONE DR, RALEIGH, NC 27609-4713
(919) 610-5172
(919) 896-7957

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
392
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
1137
NC
101YP2500X
Professional Counselor
Primary
6867
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6111980
NC
Enumeration date
09/13/2007
Last updated
05/03/2013
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